EBQ:Denver Screening Criteria

Background

• Used to screen for injury to the carotid or vertebral vessels after blunt head and neck trauma (BCVI - blunt cerebrovascular injury)
• A CTA to evaluate for VAI should be obtained in those meeting the modified Denver Criteria

• BCVI has the highest association with cervical hyperextension and rotation, hyperflexion, or direct blunt force to head and neck

• Most injuries are diagnosed after the development of symptoms secondary to central nervous system ischemia resulting in neurologic morbidity of up to 80% and associated mortality of up to 40%.

Clinical Question

• Can clinical criteria and injury profile and risk factors successfully identify patients at risk for BCVI?

Criteria

1. Lateralizing neurologic deficit (not explained by head CT)
2. Infarct on head CT
3. Non-expanding cervical hematoma
4. Massive epistaxis
5. Anisocria or Horner Syndrome
6. GCS < 8 without significant head CT findings
7. Cervical spine fracture
8. Basilar skull fracture
9. Le Fort II or III facial fractures
10. Seatbelt sign above the clavicle
11. Cervical bruit or thrill

See Also

• Head trauma (main)
• Neck trauma
• Denver Screening Criteria