Trauma · Neurology · Vascular Surgery
Modified Denver Criteria for Blunt Cerebrovascular Injury calculator
Enter the published formula inputs below to calculate and interpret this score.
Clinical inputs
Allowed range: 18–110 years
Adults 18 years or older. A cervical bruit counts only under 50 years.
Result
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Clinical inputs
- Age (years)Accepted range: 18 to 110
- Arterial hemorrhage from the neck, nose, or mouth
- Cervical bruit
- Expanding cervical hematoma
- Focal neurologic deficit
- Neurologic deficit inconsistent with the head CT
- Stroke on CT or MRI
- High-energy transfer mechanism
- Displaced midface fracture (LeFort II or III)
- Mandible fracture
- Complex skull, basilar skull, or occipital condyle fracture
- Closed head injury consistent with diffuse axonal injury and GCS below 6
- Cervical spine injury from the Figure 1 list
- Near hanging with anoxic brain injury
- Clothesline injury or seat-belt abrasion with marked swelling, pain, or altered mental status
- Traumatic brain injury with thoracic injuries
- Scalp degloving
- Thoracic vascular injury
- Blunt cardiac rupture
Primary source
Burlew CC et al. Blunt cerebrovascular injuries: redefining screening criteria in the era of noninvasive diagnosis. J Trauma Acute Care Surg. DOI: 10.1097/TA.0b013e31823de8a0. PMID: 22327974. Figure 1, the new Denver screening guideline: signs are potential arterial hemorrhage from the neck, nose, or mouth; cervical bruit in a patient younger than 50 years; expanding cervical hematoma; focal neurologic deficit (TIA, hemiparesis, vertebrobasilar symptoms, or Horner syndrome); neurologic deficit inconsistent with the head CT; and stroke on CT or MRI. Risk factors require a high-energy transfer mechanism and one of: displaced midface fracture (LeFort II or III), mandible fracture, complex skull fracture or basilar skull fracture or occipital condyle fracture, closed head injury consistent with diffuse axonal injury and GCS below 6, cervical subluxation or ligamentous injury or transverse-foramen fracture or vertebral-body fracture or any fracture of C1–C3, near hanging with anoxic brain injury, clothesline injury or seat-belt abrasion with marked swelling, pain, or altered mental status, traumatic brain injury with thoracic injuries, scalp degloving, thoracic vascular injury, or blunt cardiac rupture. The conclusion says screening algorithms should be modified to include these expanded criteria. (2012)
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