Title: How to identify blunt cervical vascular injuries<br/>Author: Robert Flint<br/><a href='http://umem.org/profiles/faculty/2561/'>[Click to email author]</a><hr/><p class="p1" style="margin: 0px; font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 14px; line-height: normal; font-family: Helvetica; -webkit-text-stroke-color: rgb(255, 255, 255);">
        <span class="s1" style="font-kerning: none;">Missing blunt cervical vascular injuries can lead to delayed catastrophic sequela such as stroke. Usie the epanded Denver criteria to help you identify these injuries.</span></p>
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        <span class="s1" style="font-kerning: none;"><b>Expanded Denver criteria for BCVI</b></span></p>
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        <span class="s1" style="font-kerning: none;">-Signs/symptoms of BCVI</span></p>
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        <span class="s1" style="font-kerning: none;">Potential arterial hemorrhage from neck/nose/mouth<br />
        Cervical bruit in patient less than 50 years old<br />
        Expanding cervical hematoma<br />
        Focal neurologic defect: TIA, hemiparesis, vertebrobasilar symptoms, Horner's syndrome<br />
        Neurologic deficit inconsistent with head CT<br />
        Stroke on CT or MRI</span></p>
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        <span class="s1" style="font-kerning: none;">-Risk factors for BCVI</span></p>
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        <span class="s1" style="font-kerning: none;">High-energy transfer mechanism<br />
        Displaced midface fracture (LeFort II or III)<br />
        Mandible fracture<br />
        Complex skull fracture/basilar skull fracture/occipital condyle fracture<br />
        Severe TBI with GCS less than 6<br />
        Cervical spine fracture, subluxation, or ligamentous injury at any level<br />
        Near hanging with anoxic brain injury<br />
        Clothesline type injury or seat belt abrasion with significant swelling, pain, or altered mental status<br />
        TBI with thoracic injuries<br />
        Scalp degloving<br />
        Thoracic vascular injuries<br />
        Blunt cardiac rupture<br />
        Upper rib fractures</span></p>
<fieldset><legend>References</legend>

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        <span class="s1" style="font-kerning: none;">Protect that Neck! Management of Blunt and Penetrating Neck Trauma<span class="Apple-converted-space">  </span><a href="https://www.emed.theclinics.com/article/S0733-8627(22)00072-4/fulltext#">Julie La, MD, MESc</a> <a href="https://www.emed.theclinics.com/article/S0733-8627(22)00072-4/fulltext#">Tim Chaplin, MD</a> <a href="https://www.emed.theclinics.com/article/S0733-8627(22)00072-4/fulltext#">Chris Evans, MD</a> :<a href="https://doi.org/10.1016/j.emc.2022.09.005">https://doi.org/10.1016/j.emc.2022.09.005</a></span></p>
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