Appendix H: Screening criteria for blunt cerebrovascular injury (BCVI)
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Screening criteria for BCVI
- Severe cervical hyperextension/rotation or hyperflexion, particularly if associated with
- Displaced mid-face or complex mandibular fracture
- Closed head injury consistent with diffuse axonal injury
- Near hanging resulting in anoxic brain injury
- Seat belt abrasion or other soft tissue of the anterior neck resulting in significant swelling or altered mental status
- Basilar skull fracture involving the carotid canal
- Arterial hemorrhage
- Cervical bruit
- Expanding cervical hematoma
- Focal neurological deficit
- Neurologic examination incongruous with CAT scan findings
- Ischemic stroke on secondary CAT scan
- High-energy transfer mechanism with
- Lefort II or III fracture
- Cervical spine fracture patterns: subluxation, fractures extending into the transverse foramen, fractures of the C1-C3
- Basilar skull fracture with carotid canal involvement
- Diffuse axonal injury with GCS ≤6
- Near hanging with anoxic brain injury