Ver el código de «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)'''<ref>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. </ref><ref>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. [http://archsurg.jamanetwork.com/data/Journals/SURG/9575/sws3014.pdf PDF]</ref>
*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<ref> Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening for blunt cerebrovascular injuries. Am J Surg. 1999;178:517–522.</ref>

*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%.<ref>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</ref>

==Clinical Question==
*Can clinical criteria and injury profile and risk factors successfully identify patients at risk for BCVI?

==Conclusion==

==Criteria==
#Lateralizing nueurologic deficit (not explained by head CT)
#Infarct on head CT
#Non-expanding cervical hematoma
#Massive [[epistaxis]]
#Anisocria or [[Horner Syndrome]]
#GCS < 8 without significant head CT findings
#[[Cervical Spine Injuries|Cervical spine fracture]]
#Basilar skull fracture
#[[Le Fort Fractures|Le Fort]] II or III facial fractures
#Seatbelt sign above the clavicle
#Cervical bruit or thrill

==Validation==

==See Also==
{{Head Neck Trauma}}

==Sources==

[[Category:Trauma]][[Category:EBQ]]
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