ToolsCalculators
Modified Denver criteria for blunt cerebrovascular injury
Signs and risk factors prompting CT-angiography screening for BCVI after blunt trauma.
Modified Denver criteria for blunt cerebrovascular injury
Arterial haemorrhage from neck, nose or mouth
Cervical bruit in patient younger than 50
Expanding cervical haematoma
Focal neurological deficit (TIA, hemiparesis, vertebrobasilar signs, Horner syndrome)
Neurological exam not explained by head CT
Ischaemic stroke on follow-up CT
High-energy mechanism with Le Fort II or III facial fracture
Cervical spine fracture: subluxation, transverse-foramen involvement, or C1-C3
Basilar skull fracture involving the carotid canal
Diffuse axonal injury with GCS <6
Near-hanging with anoxic brain injury
Seatbelt/clothesline neck injury with swelling, pain or altered mental status
ResultNo criterion met
No modified Denver criterion present; routine BCVI screening not triggered.
- Criteria present
- 0
When to use
- Deciding which blunt trauma patients need CT-angiography screening for carotid/vertebral injury.
Formula
Any single sign/symptom or high-risk injury pattern present -> screen with CT angiography of the neck.
Pearls and pitfalls
- BCVI is typically clinically silent before ischaemic stroke, so screening is mechanism-driven.
- Skull-base fracture involving the carotid canal is among the strongest risk factors.