Blunt Cerebrovascular Injuries: Screening and Diagnosis

Abstract

This review focuses on the origins of research in blunt cerebrovascular injuries (BCVI) and highlights recent developments in BCVI screening and diagnosis. An emphasis is made on the evolution of screening guidelines and the role for a computed tomography angiography (CTA)-based approach to the diagnosis of BCVI. The expanded Denver criteria first published in 2012 have been widely adopted in many trauma centers. Increased awareness and broadened screening have led to an increased rate of diagnosis in BCVI among blunt trauma patients. Current research efforts are focused on refining and improving diagnostic algorithms to improve patient selection for screening and to avoid missed injuries among blunt trauma patients. BCVI complicates between 1 and 3% of all blunt trauma admissions, and clinicians must have a high index of suspicion for this injury. Early and aggressive screening has decreased stroke rates and prevented unnecessary morbidity and mortality in this patient population. Future research will further improve institutional processes of identifying patients and instituting rapid treatment.