Systematic Screening for Blunt Cervical Vascular Injury Reduces Time to Diagnosis and Incidence of Stroke

Prompt diagnosis and treatment of blunt cervical vascular injury (BCVI) to the extracranial internal carotid or vertebral arteries can lower risk for stroke or death. In December 1999, a level I trauma center in Texas instituted modified Denver criteria for screening for BCVI; the criteria are lateralizing neurological deficit not explained by head computed tomography, infarct on head CT, nonexpanding cervical hematoma, massive epistaxis, Horner syndrome, Glasgow Coma Scale score <8 not explained by head CT, cervical spine fracture, basilar skull fracture, severe facial fracture (Le Fort II or III), seat-belt sign above clavicle, and cervical bruit or thrill. These authors compared time to diagnosis and stroke rates in patients deemed at ri…