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.
Expanded Denver criteria for BCVI
-Signs/symptoms of BCVI
Potential arterial hemorrhage from neck/nose/mouth Cervical bruit in patient less than 50 years old Expanding cervical hematoma Focal neurologic defect: TIA, hemiparesis, vertebrobasilar symptoms, Horner's syndrome Neurologic deficit inconsistent with head CT Stroke on CT or MRI
-Risk factors for BCVI
High-energy transfer mechanism Displaced midface fracture (LeFort II or III) Mandible fracture Complex skull fracture/basilar skull fracture/occipital condyle fracture Severe TBI with GCS less than 6 Cervical spine fracture, subluxation, or ligamentous injury at any level Near hanging with anoxic brain injury Clothesline type injury or seat belt abrasion with significant swelling, pain, or altered mental status TBI with thoracic injuries Scalp degloving Thoracic vascular injuries Blunt cardiac rupture Upper rib fractures
