Car-pedestrian Accidents Research Articles

SIMULATION OF CAR-PEDESTRIAN CRASH: INJURY ASSESSMENT AND IMPACT POSITIONS

In car-pedestrian collisions, pedestrian fatal injuries account for a great number of health risks in the world. A real-world accident case with a medical examination record would improve the reliability of simulation of car-pedestrian accidents but is rarely captured. The goal of this report was to assess the pedestrian injuries, and impact positions. A case of a pedestrian impacted by a car traveling at a speed of 22 km/hr was simulated using the MAthematical DYnamic MOdel (MADYMO) program. The results showed that Abbreviated Injury Score one (AIS1) head injury and Abbreviated Injury Score two (AIS2) toe fracture are caused by pedestrian impact with windshield and wheel. The maximum head linear acceleration and right foot force that led to head injuries and toe fractures are 1688.61 m/s2 and 15799.00 N, respectively. The results obtained in terms of head impact location, left forearm impact, and the right foot impact positions are comparable with the real-world road accident. This report can help in the future design of automobiles that are friendly to vulnerable pedestrians.

P0213 / #2008: THE EPIDEMIOLOGY OF PEDIATRIC POLYTRAUMA AND ORTHOPEDIC INJURIES: 12-YEAR ANALYSIS OF A LEVEL-1 TRAUMA CENTER (2007-2019)

Aims & Objectives: We present a retrospective study of pediatric polytrauma patients admitted to the pediatric Intensive Care Unit (ICU) of a tertiary university hospital in Europe. Methods: Data retrieved from 2007 to 2019 included mechanism and site of injury, pre-hospital and in-hospital trauma care, ICU length-of-stay (LOS), and in-hospital mortality. Results: 217 patients were included (age 10,7 ± 4,86 years; 66% male). Motor vehicle accidents (MVA) (44,4%) and car-pedestrian accidents (25,9%) were the leading mechanisms of injury, followed by falls from height (21,8%; 4,2% sports-related), penetrating trauma (3,3%) and suicide attempts (2,3%). On pre-hospital assessment, 60% of children had documented loss of consciousness; of these, more than half had severe brain injury (GCS<9). The most frequent injury sites were brain (74%) and skeleton (73%). Vertebral fractures were the most common orthopedic injury (19%), followed by pelvic (16,6%) and femur (15,2%) fractures. Patients with orthopedic trauma had significantly longer ICU LOS (5,1 ± 2,76 vs 3,1 ± 1,16; p=0,007); those with 3 or more fracture sites had greater needs for blood transfusion (20 vs 4 mL/kg; p=0,016). MVA were associated with highest incidence of orthopedic severe injuries (p<0,001). Most children involved in MVA were completely unrestrained (37,5%) or using a restraint system inappropriately (6,3%). Overall ICU trauma-related mortality was 1,8% (three cases of severe brain injury and one cervical spine injury). Conclusions: The great majority of polytrauma children suffer orthopedic injuries, requiring longer ICU admission and higher transfusion volumes. Road traffic accidents remain the leading cause of severe polytrauma. Education-oriented programs are still of crucial importance for prevention.

INVESTIGATION ON RISK PREDICTION OF PEDESTRIAN HEAD INJURY BY REAL-WORLD ACCIDENTS

Head injury is the most common and fatal injury in car-pedestrian accidents. Due to the lack of human test data, real-world accident data is useful for the research on the mechanism and tolerance of head injuries. The objective of the present work is to investigate pedestrian head-brain injuries through real car-pedestrian accidents and evaluate the existed injury criteria. Seven car-to-pedestrian accidents in China were selected from the IVAC (Investigation of Vehicle Accident in Changsha) database. Accident reconstructions using multi-body models were conducted to determine the kinematic parameters associated with the injury and were used to measure head injury criteria. Kinematic parameters were input into a finite element model to run simulations on the head-brain and car interface to determine levels of brain tissue stress, strain, and brain tissue injury criteria. A binary logistic regression model was used to determine the probability of head injury risk associated with AIS3+ injuries (Abbreviated Injury Scale). The results showed that head injury criteria using kinematic parameters can effectively predict injury risk of a pedestrians’ head skull. Regarding brain injuries, physical parameters like coup/countercoup pressure are more effective predictors. The results of this study can be used as the background knowledge for pedestrian friendly car design.

Numerical simulation and analysis of influencing factors of vehicle–pedestrian accidents in untypical contact state

ABSTRACTCurrent numerical analysis of car–pedestrian accidents pays more attention to typical contact state, which means pedestrians collide with the front of vehicle, but less to untypical contact state, which means pedestrians collide with the edge of vehicle. The keystone of this study is to discover appropriate initial parameters of accidents in untypical contact state fast and accurately because numerical simulation usually takes long time. Meanwhile, functions between optimised parameters and initial input parameters in an untypical-contact-state accident are fitted by polynomial regression analysis and has achieved a high degree of accuracy. Simulation of typical case indicates that the combination of orthogonal test and polynomial regression analysis can determine appropriate initial parameters more accurately compared with orthogonal test. Furthermore, the results of numerical simulation and medical identification have achieved a high degree of consistency, which indicates that the reliability and rationality of simulation have been verified.

Reliability optimization of a novel negative Poisson’s ratio forepart for pedestrian protection

The bumper system always directly causes the injury of the pedestrian leg in the car–pedestrian accidents. Therefore, it is of practical significance to optimize the bumper structure to enhance the protective effect of the pedestrian leg. Based on the original bumper system, this work proposes a novel negative Poisson’s ratio energy-absorbing forepart with inner hexagonal cellular structure, which is designed at the lower leg impact zone between the bumper beam and the cover. The parametric model of the negative Poisson’s ratio forepart, the lower legform impactor model, and the car–pedestrian collision model are firstly established. Then, through integrating the response surface method, second-order reliability method, and archive-based micro genetic algorithm, a reliability optimization design is further conducted for the negative Poisson’s ratio forepart based on the deterministic optimization results. Simulation results show that the optimized negative Poisson’s ratio forepart not only can significantly enhance the reliability and robustness, but also improve the protective effect of the pedestrian leg.

Bumper shape design for pedestrian safety

The main cause of leg injuries is the bumper during car-pedestrian accidents. Bumper geometry and bumper material have the greatest effect on pedestrian leg injury. The first objective of this study is to evaluate the effects of bumper shape on pedestrian leg injuries. This study uses three bumper shapes on three car models to evaluate the effects of bumper geometry on pedestrian leg injury: A Ford Taurus, Dodge Intrepid, and Dodge-Neon. Then, based on the results of the impact between legform and bumper, this study chooses the best bumper shape that results in the least injury to the pedestrian’s leg. The second objective of this study is to design a new bumper. Using some conclusions regarding the effects of bumper shape on the pedestrian leg injuries, a new pedestrian-friendly bumper was designed. This bumper satisfies EEVC/WG17 safety requirements regarding pedestrian leg injuries. The analyzed models and results obtained could help evaluate pedestrian friendliness of a vehicle and guide the future designing and development of pedestrian friendly vehicle technologies.

A Method to Evaluate Vehicle Impact Speeds in Passenger Car-Pedestrian Accidents

This paper aimed to research the relationship between the wrap around distance (WAD) to head contact and vehicle impact speed based on real pedestrian traffic accidents with video. A team was established to collect passenger car-pedestrian accident cases occurring between July 2011 and July 2015 in Chongqing, China. A total of 15 pedestrian crashes were selected into the sample. Impact speeds were calculated by a video analysis technology, and the WAD was revised according to the average height of pedestrians involved in the sample. The relationship between the WAD and impact speed was analyzed using linear regression analysis. We propose a method to evaluate the impact speed in passenger car-pedestrian. These results will contribute to the development of judicial identification and research of pedestrian injury.

실험계획법을 이용한 SUV의 보행자 보호 시스템 설계

The mortality rate of car-pedestrian accidents is quite high, compared to the frequency of accidents. Researches on pedestrian protection are being actively performed worldwide. The A-pillar and lower part of the wind shield cause the most serious damage to the pedestrians. Typical devises to protect the pedestrians are the hood lift system and pedestrian airbag. The design of such devices for an sport utility vehicle is performed based on a design process using design of experiments (DOE). The design results are obtained by an orthogonal array (OA), analysis of mean (ANOM) and analysis of variance (ANOVA). A metamodel is also used in the design process.

Epidemiologic Study of Trauma Patients Admitted to a Level 1 Trauma Center in Shiraz: One Year Survey

Background: Traumatic injuries exert significant burden on human populations around the world. Iran as a developing country is at top 5 deadliest countries regarding injuries; however, few studies have examined the descriptive epidemiology of trauma in Iran. Objectives: To describe injuries regarding age, gender and injury mechanism and also time trend in emergency departments of Shahid Rajaee Trauma Center affiliated to Shiraz University of Medical Sciences. Patients and Methods: This descriptive cross-sectional study was carried out on all trauma patients (n = 21542) admitted to Shahid Rajaee Trauma Hospital (level I trauma referral center in Shiraz) between March 2011 and March 2012. Data were analyzed separately by age, gender, month of admission, and injury mechanisms (motorcycle collision, car-pedestrian accidents, car-car accidents, fall from height, stab wounds and gunshot injuries). Results: With a mean age of 36.0 ± 17.2 years, a total number of 21542 patients were visited, 16524 (76.7%) of whom were male. The male to female ratio was 3.3:1 with injured men being significantly younger than women (mean age 33.7 + 16.6 and 43.6 ± 19.2 years, respectively). There were 1492 trauma victims older than 60 years accounting for the smallest proportion of the population (6.92%). On admission, 1699 patients (7.9%) required cardiopulmonary cerebral resuscitation (CPCR) with a sex ratio of 2:1. Among those requiring CPCR, falling down was the major cause (45.24%) of injury in elderly (patients over 60 year) and car accident in those under 60 year (43.94%). Conclusions: Injuries affect all age groups; however, the disproportionately at risk population is the productive youth. Preventive strategies should focus on reducing trauma incidence among young men at population level. Considering the higher number of incidents occurring in mid spring and late summer, authorities should devise preventive plans mainly through alteration of traffic rules in this period.

Finite element analysis of pedestrian lower limb fractures by direct force: The result of being run over or impact?

The elucidation and prediction of the biomechanics of lower limb fractures could serve as a useful tool in forensic practices. Finite element (FE) analysis could potentially help in the understanding of the fracture mechanisms of lower limb fractures frequently caused by car–pedestrian accidents. Our aim was (1) to develop and validate a FE model of the human lower limb, (2) to assess the biomechanics of specific injuries concerning run-over and impact loading conditions, and (3) to reconstruct one real car–pedestrian collision case using the model created in this study. We developed a novel lower limb FE model and simulated three different loading scenarios. The geometry of the model was reconstructed using Mimics 13.0 based on computed tomography (CT) scans from an actual traffic accident. The material properties were based upon a synthesis of data found in published literature. The FE model validation and injury reconstruction were conducted using the LS-DYNA code. The FE model was validated by a comparison of the simulation results of three-point bending, overall lateral impact tests and published postmortem human surrogate (PMHS) results. Simulated loading scenarios of running-over the thigh with a wheel, the impact on the upper leg, and impact on the lower thigh were conducted with velocities of 10m/s, 20m/s, and 40m/s, respectively. We compared the injuries resulting from one actual case with the simulated results in order to explore the possible fracture bio-mechanism. The peak fracture forces, maximum bending moments, and energy lost ratio exhibited no significant differences between the FE simulations and the literature data. Under simulated run-over conditions, the segmental fracture pattern was formed and the femur fracture patterns and mechanisms were consistent with the actual injury features of the case. Our study demonstrated that this simulation method could potentially be effective in identifying forensic cases and exploring of the injury mechanisms of lower limb fractures encountered due to inflicted lesions. This model can also help to distinguish between possible and impossible scenarios.

Coupling Lateral Bending and Shearing Mechanisms to Define Knee Injury Criteria for Pedestrian Safety

Objective: In car–pedestrian accidents, lateral bending and shearing kinematics have been identified as principal injury mechanisms causing permanent disabilities and impairments to the knee joint. Regarding the combined lateral bending and shearing contributions of knee joint kinematics, developing a coupled knee injury criterion is necessary for improving vehicle countermeasures to mitigate pedestrian knee injuries. Methods: The advantages of both experimental tests and finite element (FE) simulations were combined to determine the reliable injury tolerances of the knee joint. First, 7 isolated lower limb tests from postmortem human subjects (PMHS) were reported, with dynamic loading at a velocity of 20 km/h. With the intention of replicating relevant injury mechanisms of vehicle–pedestrian impacts, the experimental tests were categorized into 3 groups by the impact locations on the tibia: the distal end to prioritize pure bending, the middle diaphysis to have combined bending and shearing effects, and the proximal end to acquire pure shearing. Then, the corresponding FE model was employed to provide an additional way to determine exact injury occurrences and develop a robust knee injury criterion by the variation in both the lateral bending and shearing contributions through a sensitivity analysis of impact locations. Results: Considering the experimental test results and the subsequent sensitivity analysis of FE simulations, both the tolerances and patterns of knee joint injuries were determined to be influenced by impact locations due to various combined contributions of lateral bending and shearing. Both medial collateral ligament and cruciate ligament failures were noted as the onsets of knee injuries, namely, initial injuries. Finally, a new injury criterion categorized by initial injury patterns of knee joint was proposed by coupling lateral bending and shearing levels. Conclusions: The developed injury criterion correlated the combined joint kinematics to initial knee injuries based on subsegment tests and FE simulations conducted with a biofidelic lower limb model. This provides a valuable way of predicting the risk of knee injury associated with vehicle–pedestrian crashes and thereby represents a further step to promote the design of vehicle countermeasures for pedestrian safety.

A study of pedestrian and bicyclist exposure to head injury in passenger car collisions based on accident data and simulations

The objective was to assess head injury risks and kinematics of adult pedestrians and bicyclists in primary impact to the passenger cars and secondary impact to the ground using real world accident data and computer reconstructions of the accidents. For this purpose, a subsample of 402 pedestrians and 940 bicyclists from the GIDAS database, Germany, was used for the statistical analysis, from which 22 pedestrian and 18 bicyclist accidents were further selected for reconstruction. PC-Crash was used to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence, and thrown distance. These conditions were employed to identify the initial conditions in reconstruction in MADYMO program. A comparable analysis was conducted based on the results from accident analysis and computer reconstructions for the impact configurations and the resulting injury patterns of pedestrians and bicyclists in view of head injury risks. Differences in HIC, head-relative impact velocity, linear acceleration, maximum angular velocity and acceleration, contact force, thrown distance, Wrap Around Distance (WAD), and head contact time were evaluated. Injury risk curves were generated by using a logistic regression model for vehicle impact velocity. The results indicate that bicyclists suffered less severe injuries compared with severity of pedestrian injuries. In the selected samples, the AIS 2+ and AIS 3+ head injury risks for pedestrians are 50% probability at impact speed of 38.87km/h and 54.39km/h respectively, while for bicyclists at 53.66km/h and 58.89km/h respectively. The findings of high injury risks suggested that in the area with high frequency car-pedestrian accidents, the vehicle speed limit should be 40km/h, while in the area with high frequency car-cyclist accidents the vehicle speed limit should be 50km/h.

Design and Validation of a Structural Flexibility Pedestrian Lower Legform

Nowadays automobiles are with good performance and comfortable; however, safety gradually becomes an issue because of high incidence of traffic accidents. Except for occupants injured in traffic accidents, other vulnerable road users, like pedestrians, are also in danger. Pedestrians make up 16% of all road traffic fatalities in the EU and over 30% in Japan, their percentage can exceed 50% in developing countries. In nonfatal car-pedestrian accidents, lower extremities are the most commonly injured body parts.EEVC proposed sub-system tests to evaluate responses and injuries of pedestrians in lateral car-pedestrian accidents, in which lower legform to bumper tests are used to investigate leg injuries. Now the TRL-PLI and Flex-PLI have developed, and both have their pros and cons. In this study it is to modify existing lower legform impactor model, and the new model is still with high biofidelity, inexpensive and easy to manufacture and assemble. The new model can then be made physically and applied to relevant tests and development of pedestrian passive safety system.In order to ensure the biofidelity of new legform impactor model, it is needed to conduct certification tests. Setup and biofidelic corridor of certification tests are based on PMHS tests. This study constructs the finite element model of human-like legform impactor model and makes use of LS-DYNA to perform the same tests as PMHS to evaluate its biofidelity. Certification tests consist of component and assembly tests. Component tests include 3-point leg bending tests and 4-point knee joint bending tests, and assembly tests comprise shearing and bending tests, all above in lateral direction. After finishing all the certification tests, testing results are analyzed and compared with those of two existing legform impactors. One legform to bumper test is conducted as a case of application.

Injury tolerance of tibia for the car–pedestrian impact

Lower limbs are normally the first contacted body region during car–pedestrian accidents, and easily suffer serious injuries. The previous tibia bending tolerances for pedestrian safety were mainly developed from three-point bending tests on tibia mid-shaft. The tibia tolerances of other locations are still not investigated enough. In addition, tibia loading condition under the car–pedestrian impact should be explored to compare with the three-point bending. This work aims to investigate the injury tolerance of tibia fracture with combined experimental data and numerical simulation. Eleven new reported quasi-static bending tests of tibia mid-shaft, and additional eleven dynamic mid-shaft bending test results in the previous literature were used to define injury risk functions. Furthermore, to investigate the influence of tibia locations on bending tolerance, finite element simulations with lower limb model were implemented according to three-point bending and pedestrian impact conditions. The regressive curve of tibia bending tolerance was obtained from the simulations on the different impact locations, and indicated that tibia fracture tolerance could vary largely due to the impact locations for the car–pedestrian crash.

Two-dimensional numerical analysis of impact response of the human tibia in Car-pedestrian accidents

Objective The purpose of this paper was to use a new biphasic tibia model to develop a two-dimensional numerical method for simulating impact responses of human tibia in car-pedestrian accidents. Methods The geometry of tibia model was reconstructed from CT scans of the left tibia of a living human volunteer. A poroelastic approach was utilized to establish the governing equations of the model and the finite element method was applied to solve these governing equations. Both cortical and cancellous components of tibia were represented using a material model consisting of solid phase (matrix) and fluid phase (marrow). A lateral-medial impact direction was selected in the simulation analysis and the impact responses of the pedestrian tibia during 0-200 ms were analyzed. Results The bending deformation of the tibia predicted by the computer simulation was primarily concentrated on the impact zones. The displacement response of Node 107 in the impact zone indicated a peak displacement of -6 mm at around 75 ms, and the significant time delay between the impact force and the displacement response of the skeleton. The axial stress response at the center of element E77 in the impact zone indicated a peak stress of 140 MPa at around 30 ms,and the significant time delay was observed between the impact force and the axial stress response of the skeleton, too. Conclusion This research developed a two-dimensional numerical method for simulating impact responses of human tibia in car-pedestrian accidents. It was able to approximately simulate the bending deformation, lateral displacement response and axial stress response of pedestrian tibia in the impact zones,and the effects of the fluid phase on the solid phase. More in-depth investigation is helpful to further the biofidelity of tibia dynamics model. Key words: Tibia; Cancellous bone; Compact bone; Pedestrian; Accidents; Dynamic responses; Porous media

Improvement of accelerometers for pedestrian headform impactors in testing following Japanese vehicle safety regulations

Most pedestrian deaths in car–pedestrian accidents are due to head injuries. In 2005, the Japanese Ministry of Land, Infrastructure, Transport and Tourism (J–MLIT) began assessing the safety of bonnets impacting on pedestrians' heads using headform impactors with designated technical specifications. J–MLIT has used Type Approval Regulation Version 1 of headform impactors fitted with small un–damped accelerometers since 2005. Meanwhile, oil–damped accelerometers have been used by J–MLIT Type Approval Regulation Version 2 headform impactors since 2010. This paper summarises the development of pedestrian headform impactors used in headform impact tests in Japan and points to increasing safety levels.

Design of pedestrian friendly vehicle bumper

Car-pedestrian accidents take thousands of lives worldwide annually. Therefore, pedestrian protection is an important issue in traffic safety. How to consider a pedestrian friendliness vehicle and then propose pedestrian protection methods are urgent works for minimizing pedestrian injury. For designing a pedestrian friendly vehicle bumper, this study adopts the European Enhanced Vehicle-safety Committee/ Working Group 17 (EEVC/WG17) regulations of legform impactor to bumper tests. Analyzing the pedestrian friendliness of a vehicle bumper by using LS-DYNA is described in detail. Simulation results were analyzed to identify the reasons for the unfriendliness. Furthermore, the analysis of the influence of bumper structure on pedestrian leg was performed and then some guideline was suggested. The analyzed models and results obtained could help evaluate pedestrian friendliness of a vehicle and guide the future development of pedestrian friendly vehicle technologies.

Optimization of bonnet thickness with respect to pedestrian safety

Head and face injuries in car–pedestrian accidents account for 60 per cent of all pedestrian fatal injuries, whereas 17.3 per cent of head injuries were due to the bonnet. The above values demonstrate the necessity to consider more carefully the role of the bonnet in pedestrian head safety. Redesigning the bonnet structure to improve pedestrian protection has recently received considerable attention by automobile manufacturers and industry institutes. However, there is a lack of research that considers methods of choosing the most effective thicknesses of bonnet skin and bonnet reinforcement with respect to pedestrian safety. This study analyses the effects of the bonnet skin and bonnet reinforcement thicknesses on pedestrian head injury by performing simulations of headform-impactor-to-bonnet tests according to the European Enhanced Vehicle-safety Committee Working Group 17 regulations for different thicknesses. An optimization method of selecting the most effective thicknesses of bonnet skin and bonnet reinforcement will be introduced. Many positions on the bonnet surface are considered to enhance pedestrian friendliness by using this method. Moreover, a bonnet with the optimal thicknesses is not only pedestrian friendly but also as stiff as possible. Based on the proposed method, this study presents steps for optimizing the bonnet skin and bonnet reinforcement thicknesses using a particular automobile model.

Investigation of 184 passenger car–pedestrian accidents

In China, pedestrians were the most common and the most vulnerable of road users, meaning pedestrians were involved in vehicle-pedestrian accidents more frequently. Little attention has been paid to the investigation of such accidents. One surveying group was built to randomly collect vehicle-pedestrian accidents and analyse these accidents from the vehicle–pedestrian crash characteristics and the relationships between the pedestrian injury outcome and the impact speed. 184 pedestrians were injured and killed in these investigated passenger-car-pedestrian accidents. Among the 184 pedestrians involved in these accidents, 151 were crossing road arbitrarily (82.1%). There were only 17 accidents where the pavement and guardrail satisfied the safety standard. The males were the majority of the casualties (64.7%). Pedestrian injury localisations in head, extremities, chest and torso accounted for 68.5%, 68.5%, 24.5% and 15.8%, respectively. Of the fatalities, 71.4% resulted from brain injury. The injury outcome in elderly pedestrians was more severe and the head severe injury proportion in children was more than that of an adult. Multiple injuries were common in pedestrians. The pedestrian injury outcome was relative to the impact speed, i.e. faster the impact speed, higher was the pedestrian's Injury Severity Score (ISS). There were no fatalities under the impact speed of 30 km/h and there were 4.4% of fatalities at the impact speed of 30∼39 km/h. When the impact speed was above 80 km/h, the pedestrians were severely injured or even killed.

Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma

BackgroundBlunt carotid and vertebral artery injury (BCVI) occur infrequently. The incidence of this type of injury is difficult to determine as many emergency room patients are neurologically asymptomatic. The statistics have not been reported in Brazil. The objectives of the current study were: To evaluate the accuracy of criteria used to recommend angiotomography in the diagnosis of cervical BCVI in 100 patients with blunt cervical trauma in the trauma services section of a Brazilian quaternary care hospital.MethodsDuring a 30-month (2006-2008), all patients admitted to the emergency room of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo with blunt cervical trauma and potential risk of cervical vessel injury, were subjected to cervical angiotomography to diagnose BCVI. The data analyzed are presented as mean ± standard deviation, and statistical analyses included Chi-square and Fisher's exact tests, and the Mann-Whitney test.ResultsDuring the study period 2467 blunt trauma patients were admitted. In 100 patients that met the criteria for inclusion in the study, angiotomography identified 23 with BCVI, including 17 males and six females. The mean patient age was 34.81 ± 14.84 years. Car crash (49%) and car-pedestrian accidents (24%) were the most frequent causes of injury. Ten patients had internal carotid artery injuries, two patients had common carotid artery injuries, and 11 patients had vertebral artery injuries. Seven patients presented with Degree I arterial injuries, 10 patients presented with Degree II artery injuries, four patients presented with Degree IV artery injuries, one patient presented with a Degree V artery injury, and one patient had a carotid fistula. Seven out of the 23 patients with BCVI (30.4%) presented with cervical vertebrae fractures, and 11 out of the 23 patients with BCVI (47.8%) presented with facial fractures (LeFort II and III).ConclusionsAlthough there is no consensus regarding the criteria that should be used to indicate angiotomography for BCVI diagnosis, we conclude that the criteria used in the current study led to a diagnosis of BCVI in 0.93% of 2,467 trauma patients, BCVI injuries were associated with more severe traumas and did not affect mortality.