Emergency Medicine Book

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Denver Screening Criteria for Blunt Cerebrovascular Injury

Aka: Denver Screening Criteria for Blunt Cerebrovascular Injury, Denver Criteria for BCVI
  1. See Also
    1. Blunt Neck Trauma
    2. Carotid Artery Injury in Blunt Neck Trauma
    3. Vertebral Artery Injury in Blunt Neck Trauma
  2. Indications
    1. Determine need for CT Angiogram of Neck Vascular Injury in Blunt Force Trauma
  3. 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
  4. Criteria: Risk Factors for Blunt Cerebrovascular Injury
    1. High energy mechanism of injury
      1. Le Fort II or III mid-face Fractures
      2. Cervical Spine Fractures (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
  5. References
    1. Kalsi, Kaufman and Hudson (2018) Crit Dec Emerg Med 32(10): 3-10
    2. Biffl (1999) J Trauma 47(5):845-53 +PMID:10568710 [PubMed]
    3. Biffl (1999) Am J Surg 178(6):517-22 +PMID:10670864 [PubMed]

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