II. Indications
- Determine need for CT Angiogram of Neck Vascular Injury in Blunt Force Trauma
III. Criteria: Signs and symptoms of Blunt Cerebrovascular Injury
- Arterial Hemorrhage
- Cervical Bruit
- Expanding neck Hematoma
- Focal neurologic deficits that do not correlate with Head CT findings
- Cerbrovascular accident on CT Imaging
IV. Criteria: Risk Factors for Blunt Cerebrovascular Injury
- High energy mechanism of injury
- Le Fort II or III mid-face Fractures
- Cervical Spine Fractures (including subluxations)
- Basilar Skull Fracture and involvement of carotid canal
- Other risks
- Diffuse Axonal Injury with GCS <8
- Near hanging with anoxic brain injury
- Seat Belt Sign (or other soft tissue neck injury)
- Especially if significant associated swelling or Altered Level of Consciousness
V. References
- Kalsi, Kaufman and Hudson (2018) Crit Dec Emerg Med 32(10): 3-10
- Biffl (1999) J Trauma 47(5):845-53 +PMID:10568710 [PubMed]
- Biffl (1999) Am J Surg 178(6):517-22 +PMID:10670864 [PubMed]