Template:Denver screening criteria background

Background

  • Used to screen for vertebral and carotid artery dissection and/or injury after blunt head and neck trauma (BCVI - blunt cerebrovascular injury)[1][2]
  • 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[3]
  • 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%.[4]
Algorithm for evaluation of BCVI with high risk criteria based on Memphis and Denver Screening Criteria
  1. Bromberg, William. et al. Blunt Cerebrovascular Injury Practice Management Guidelines: The Eastern Association for the Surgery of Trauma. J Trauma. 68 (2): 471-7, Feb 2010.
  2. Cothren CC, Moore EE, Biffl WL, et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg. 2004;139:540–545; discussion 545–546. PDF
  3. Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening for blunt cerebrovascular injuries. Am J Surg. 1999;178:517–522.
  4. Davis JW, Holbrook TL, Hoyt DB, Mackersie RC, Field TO Jr, Shackford SR. Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma. 1990;30:1514–1517