Table 1:

Published screening criteria for BCVI

Name of Screening CriteriaPatients to Be Screened
Signs/Symptoms of BCVIRisk Factors of BCVI
Modifieda Denver Criteria14Arterial hemorrhage (from neck, nose, or mouth)High-energy transfer mechanism with the following:
Cervical bruit (in younger than 50 yr of age)LeFort II or III fracture
Expanding cervical hematomaBasilar skull fracture involving carotid canal
Focal neurologic defect: TIA, hemiparesis, vertebrobasilar symptoms, Horner syndromeCervical vertebral body or transverse foramen fracture, subluxation, or ligamentous injury at any level; any fracture at C1–C3
Stroke on CT or MRIClosed head injury consistent with DAI and GCS <6
Neurologic deficit inconsistent with head CTNear-hanging with anoxia
Clothesline-type injury or seat belt abrasion with significant swelling, pain, or altered mental status
Memphis Criteria16Cervical spine fracture
Neurologic exam not explained by brain imaging
Horner syndrome
LeFort II or III facial fractures
Skull base fractures involving the foramen lacerum
Neck soft-tissue injury (eg, seat belt injury or hanging)
  • Note:—DAI indicates diffuse axonal injury; GCS, Glasgow Coma Scale.

  • a Suggested expansion: occipital condyle fractures, mandibular fractures, traumatic brain injuries with thoracic injuries, scalp degloving, thoracic vascular injuries, and blunt cardiac rupture.9