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Denver Screening Criteria for Blunt Cerebrovascular Injury

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Denver Screening Criteria for Blunt Cerebrovascular Injury, Denver Criteria for BCVI, Revised Denver Criteria for BCVI

  • See Also
  1. Blunt Neck Trauma
  2. Carotid Artery Injury in Blunt Neck Trauma
  3. Vertebral Artery Injury in Blunt Neck Trauma
  • Indications
  1. Determine need for CT Angiogram of Neck Vascular Injury in Blunt Force Trauma
  1. Suspected Arterial Hemorrhage from the neck or face
  2. Cervical Bruit in age <50 years
  3. Expanding neck Hematoma
  4. Focal neurologic deficits that do not correlate with Head CT findings
  5. Focal neurologic deficit correlating to CNS injury (e.g. TIA, Hemiparesis, Horner Syndrome, vertebrobasilar symptoms)
  6. Cerbrovascular accident on CT Imaging
  1. High energy mechanism of injury
    1. Displaced Le Fort II or III mid-face Fractures
    2. MandibleFracture
    3. Cervical Spine Fractures (including subluxations)
      1. Especially Fractures involving transverse foramen or C1-C3 Vertebrae
      2. Any Fracture involving the cervical transverse foramen
    4. Basilar Skull Fracture and involvement of carotid canal
    5. Complex Skull Fracture
    6. Occipital condyle Fracture
  2. Other risks
    1. Traumatic Brain Injury or Diffuse Axonal Injury with GCS <6
    2. Scalp degloving
    3. Near hanging with anoxic brain injury
    4. Seat Belt Sign (or other soft tissue neck injury such as clothesline injury)
      1. Especially if significant associated significant swelling or Altered Level of Consciousness
    5. Thoracic Injury with associated brain injury or vascular injury
    6. Upper Rib Fractures
    7. Blunt cardiac rupture
  • 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]