II. Indications

  1. Determine need for CT Angiogram of Neck Vascular Injury in Blunt Force Trauma

III. Criteria: Signs and symptoms of Blunt Cerebrovascular Injury

  1. Arterial Hemorrhage
  2. Cervical Bruit
  3. Expanding neck hematoma
  4. Focal neurologic deficits that do not correlate with Head CT findings
  5. Cerbrovascular accident on CT Imaging

IV. Criteria: Risk Factors for Blunt Cerebrovascular Injury

  1. High energy mechanism of injury
    1. Le Fort II or III mid-face Fractures
    2. Cervical SpineFractures (including subluxations)
      1. Especially Fractures involving transverse foramen or C1-C3 Vertebrae
    3. Basilar Skull Fracture and involvement of carotid canal
  2. Other risks
    1. Diffuse Axonal Injury with GCS <8
    2. Near hanging with anoxic brain injury
    3. Seat Belt Sign (or other soft tissue neck injury)
      1. Especially if significant associated swelling or Altered Level of Consciousness

V. References

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