BACKGROUND: Current literature suggests that blunt @entity130 (BCIs) and @entity1317 (BVIs) are more common than once appreciated. Screening criteria have been suggested, but only one previous study has attempted to identify factors that predict the presence of BCI/BVI. This current study was conducted for two reasons. First, we wanted to determine the incidence of BCI/BVI in our institution. Second, we wanted to determine the incidence of abnormal four-vessel cerebral angiograms ordered for injuries and signs believed to be associated with BCI/BVI and thus to determine whether the screening protocol developed was appropriate. METHODS: From August 1998, we used liberalized screening criteria for @entity1 who were prospectively identified and suspected to be at high risk for BCI/BVI if any of the following were present: anisocoria, unexplained mono-/ @entity1269 , unexplained neurologic exam, basilar skull @entity174 through or near the carotid canal, @entity174 through the foramen transversarium, @entity64 or transient @entity63 attack, massive @entity1415 , severe flexion or extension cervical spine @entity174 , massive @entity174 , @entity135 . Four-vessel cerebral angiograms were used for screening for BCI/BVI. RESULTS: Over the 18-month study period, 48 @entity1 were angiographically screened, with 21 @entity1 (44%) being identified as having a total of 19 BCIs and 10 BVIs. Nine @entity1 had unilateral carotid @entity1317 and three @entity1 had bilateral carotid @entity1317 . @entity1317 were unilateral in six @entity1 . One @entity1 had bilateral carotid @entity1317 and a unilateral @entity1317 . One @entity1 had a unilateral @entity1914 and a unilateral @entity1317 , and one @entity1 had a unilateral @entity1914 and bilateral @entity1317 . During the same study period, 2,331 @entity130 @entity1 were admitted, with 1,941 (83%) secondary to blunt @entity130 . The overall incidence of BCI/BVI was 1.1%. The frequency of abnormal angiograms ordered for @entity64 or transient @entity63 attack, massive @entity1415 , or severe cervical spine fractures was 100%. The frequency of abnormal angiograms ordered for the other indications was as follows: @entity174 through foramen transversarium, 60%; unexplained mono- or @entity1269 , 44%; basilar skull @entity174 , 42%; unexplained neurologic examination, 38%; anisocoria, 33%; and severe @entity174 , 0%. CONCLUSION: The liberalized screening criteria used in this study were appropriate to identify @entity1 with BCI/BVI. This study suggests BCI/BVI to be more common than previously believed and justifies that screening should be liberalized.

Liberalized screening for blunt carotid and XXXX is justified.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity135 :: ('MESH:D006258', 'Disease') :: ['or neck hematoma'] @entity64 :: ('MESH:D020521', 'Disease') :: ['cerebrovascular accident'] @entity174 :: ('MESH:D050723', 'Disease') :: ['facial fractures', 'fracture'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity1269 :: ('MESH:D010291', 'Disease') :: ['hemiparesis'] @entity1415 :: ('MESH:D004844', 'Disease') :: ['epistaxis'] @entity1317 :: ('MESH:D057772', 'Disease') :: ['Vertebral artery injuries', 'vertebral artery injury', 'vertebral artery injuries', 'artery injuries'] @entity1914 :: ('MESH:D020212', 'Disease') :: ['carotid artery injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['carotid injuries', 'trauma']
@entity1317 :: (MESH:D057772,Disease) :: ['vertebral artery injuries']
