Objectives: The primary objective of this study was to investigate the clinical outcomes and diagnostic management of cervical spine injuries in patients admitted to the surgical emergency department of Regiomed Hospital, Coburg, following head trauma. Specifically, the study aimed to evaluate the necessity and clinical indications for performing cervical spine CT assessments, with a particular focus on identifying the relationship between clinical symptoms and the presence of cervical spine fractures. The study hypothesized that cervical spine imaging is warranted only in adult patients with isolated head trauma who present with clinical signs and symptoms suggestive of cervical spine injury. Material and Methods: This retrospective cohort study analysed 109 patients admitted to the emergency department for traumatic brain injury (TBI) between 2022 and 2024. Data were extracted from the ORBIS and Deep Unity hospital information systems, focusing on variables such as patient demographics, mechanism of injury, Glasgow Coma Scale (GCS) scores, clinical symptoms, and the presence of cervical spine fractures. Statistical analyses were conducted using IBM SPSS Statistics 29.0.2.0 to assess correlations between these variables. Additionally, the study documented radiation doses administered during initial CT scans, including kilovoltage (kV), Computed Tomography Dose Index (CTDI), and Dose Length Product (DLP). Results: The study cohort exhibited a median age of 79 years, with a slight male predominance (52,3%). A significant finding was the substantial underutilization of GCS in initial assessments, with documentation in merely 27,5% of cases. Statistical analysis revealed a strong correlation between the presence of clinical symptoms and the incidence of cervical spine fractures, with 57.1% of symptomatic patients presenting with fractures compared to 0,98% of asymptomatic patients (p < 0,001). However, it is crucial to note that 20% of fractures occurred in asymptomatic patients, highlighting the potential risks of relying solely on clinical symptoms. Additionally, no statistically significant association was observed between the mechanism of injury and the occurrence of fractures (p = 0,875) Conclusion: The study's findings demonstrate a significant correlation between clinical symptoms and cervical spine fractures. However, the occurrence of asymptomatic fractures indicates that symptom-based assessment alone may be insufficient for comprehensive diagnosis. These findings support the judicious application of cervical spine CT imaging in high-risk populations, even in the absence of overt symptoms, to mitigate the risk of overlooking clinically silent injuries. Further-more, the observed underutilization of the GCS underscores the necessity for more consistent adherence to standardized assessment protocols in emergency. This adherence is crucial for enhancing the early detection and management of severe TBIs. In conclusion, this study advocates for a balanced approach that integrates both clinical and imaging data to optimize patient outcomes.