Denver Screening Criteria for Blunt Cerebrovascular Injury

The Denver screening criteria has been developed to aid in the diagnosis and treatment of blunt cerebrovascular injury (i.e., damage to the carotid and/or vertebral arteries) which is an increasingly recognized entity in trauma.

The Denver screening criteria are:

Focal neuorlogical deficit
Arterial hemorrhage
Cervical bruit in a patient less than 50 years of age
Expanding neck hematoma
Neurological exam inconsistent with head CT scan
Cerebrovascular accident on follow-up head CT not seen on initial head CT

The Denver screening criteria lists the following risk factors for blunt cerebrovascular injury (BCVI)

Presence of Leforte II or III fractures
Cervical spine fractures involving subluxation
Cervical spine fractures involving C1-C3
Cervical spine fractures extending into the transverse foramina
Basilar skull fractures with carotid canal involvement
Diffuse axonal injury with a Glasgow Coma Scale of 6 or less
Near hanging injuries with anoxic brain injury

Denver screening criteria Lefort 2 fracture

Lefort 2 fracture line seen in red

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