Expanded Screening Criteria for Blunt Cerebrovascular Injury (BCVI)12

 

Signs and Symptoms of BCVI

  • Arterial hemorrhage from neck, nose, or mouth.
  • Cervical bruit in patient <50 years of age.
  • Cervical hematoma.
  • Focal neurologic deficit inconsistent with head CT.
  • Ischemic change on head CT.

 

Risk Factors for BCVI

  • High-energy mechanism.
  • LeFort II or III facial fracture, or mandible fracture.
  • Skull or skull-base fracture.
  • Severe TBI, as defined by GCS < 6.
  • Cervical fracture, subluxation, or ligamentous injury.
  • “Clothesline,” “seat-belt,” or “hanging”-type mechanism of injury.
  • TBI with associated thoracic injuries.
  • Thoracic vascular injuries or upper rib fractures.
  • Scalp de-gloving injury.
  • Blunt cardiac injuries.