ArticleEmergency radiology2019
Augmenting Denver criteria yields increased BCVI detection, with screening showing markedly increased risk for subsequent ischemic stroke.
Article in Emergency radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 37 citations in OpenAlex.
- Blunt Cerebrovascular Injury: A Visual Case Report with Computed Tomography Angiography Findings Revealing Carotid and Vertebral Artery Dissection.Journal of education & teaching in emergency medicine · 2026Article
- Universal computed tomography angiography screening for blunt cerebrovascular injury: a systematic review of improved detection, clinical outcomes, and cost-effectiveness.Emergency radiology · 2026Review
- American Association for the Surgery of Trauma-World Society of Emergency Surgery Guidelines on the diagnosis and management of cervical vascular injuries.The journal of trauma and acute care surgery · 2026Article
- Traumatic Vertebral Artery Injury: Diagnosis, Natural History, and Key Considerations for Management.Journal of clinical medicine · 2025Review
- A bibliometric analysis of blunt cerebrovascular injury: the top 50 most instrumental articles.Neurosurgical review · 2025Review
- The effect of circle of willis anatomy and scanning practices on outcomes for blunt cerebrovascular injuries.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Changes in occurrence and management of laryngeal fractures at the Helsinki University Hospital during 25 years.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Vertebral Artery Dissection.BMJ case reports · 2024Article
- Blunt Cerebrovascular Injury: Are We Overscreening Low-Mechanism Trauma?AJNR. American journal of neuroradiology · 2023Article
- Blunt Cerebrovascular Injury in the Elderly With Traumatic Cervical Spine Injuries: Results of a Retrospective Multi-Center Study of 1512 Cases in Japan.Journal of neurotrauma · 2023Article
- Ankylosis of the cervical spine increases the incidence of blunt cerebrovascular injury (BCVI) in CTA screening after blunt trauma.Emergency radiology · 2022Article
- Delayed Blunt Traumatic Carotid Artery Dissection After a Scooter Accident: A Case Report.Clinical practice and cases in emergency medicine · 2022Article
- Computed tomography angiography in blunt cerebrovascular injury: navigating through perspectives and diagnostics.European radiology · 2022Article
- Routine CTA screening identifies blunt cerebrovascular injuries missed by clinical risk factors.Trauma surgery & acute care open · 2022Article
- Emergent neurovascular imaging in patients with blunt traumatic injuries.Frontiers in radiology · 2022Review
- Statistical learning of blunt cerebrovascular injury risk factors using the elastic net.Emergency radiology · 2021Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeBCVI may lead to ischemic stroke, disability, and death, while being often initially clinically silent. Screening criteria for BCVI based on clinical findings and trauma mechanism have improved detection, with Denver criteria being most common. Up to 30% of patients do not meet BCVI screening criteria. The aim of this study was to analyze the effect of augmented Denver criteria on detection, and to determine the relative risk for ischemic stroke.
methodsDenver screening criteria were augmented by any high-energy trauma of the cervical spine, thorax, abdomen, or pelvis. All acute blunt trauma WBCT including CT angiography (CTA) over a period of 38 months were reviewed retrospectively by two Fellowship-trained radiologists, as well as any cerebral imaging after the initial trauma.
results1544 WBCT studies included 374 CTA (m/f = 271/103; mean age 41.5 years). Most common mechanisms of injury were MVA (51.5%) and fall from a height (22.3%). We found 72 BCVI in 56 patients (15.0%), with 13 (23.2%) multiple lesions. The ICA was affected in 49 (68.1%) and the vertebral artery in 23 (31.9%) of cases. The most common injury level was C2, with Biffl grades I and II most common in ICA, and II and IV in VA. Interobserver agreement was substantial (Kappa = 0.674). Of 215 patients imaged, 16.1% with BCVI and 1.9% of the remaining cases had cerebral ischemic stroke (p < .0001; OR = 9.77; 95% CI 3.3-28.7). Eleven percent of patients with BCVI would not have met standard screening criteria.
conclusionsThe increase in detection rate for BCVI justifies more liberal screening protocols.
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