Table 2:

Boston Criteria17 for BCVI

First TieraSecond Tierb
Skull base fractures: petrous and basilar fracturesDAI
Any cervical spine fracturesComplex facial fractures with midface instability
Cervical spine injury (cord, vertebral body, or ligaments)Combined significant head and chest trauma
Soft-tissue injury to anterior neck with swelling/ecchymosis/hematoma/or bruitNear-hanging
Significant neurologic deficit: lateralizing neurologic deficit, TIA, Horner syndromeSeat belt abrasions on neck
Evidence of brain infarct on CTOther unexplained neurologic deficits: vertigo, tinnitus, or GCS ≤6
  • Note:—DAI indicates diffuse axonal injury; GCS, Glasgow Coma Scale.

  • a First tier criteria: CTA screening on presentation.

  • b Second tier criteria: CTA screening within 24–48 hours of presentation.