Extended Denver screening criteria present stratified by Biffl grade
| Criterion | Biffl grade; no. (%) of patients | ||
|---|---|---|---|
| 1–2 | 3 | 4 | |
| Signs or symptoms of BCVI | |||
| Potential arterial hemorrhage from neck, nose or mouth | 3 (3) | 3 (3) | 0 (0) |
| Expanding cervical hematoma | 0 (0) | 1 (3) | 1 (3) |
| Focal neurologic deficit (TIA, hemiparesis, vertebrobasilar symptoms, Horner syndrome) | 13 (3) | 6 (3) | 13 (3) |
| Neurologic examination findings incongruous with head CT findings | 1 (3) | 0 (0) | 0 (0) |
| Ischemic stroke on CT or MRI | 6 (3) | 3 (3) | 9 (3) |
| Risk factors for BCVI in setting of high-energy–transfer mechanism | |||
| Displaced midface fracture (Le Fort II or III) | 2 (3) | 1 (3) | 0 (0) |
| Mandible fracture | 6 (3) | 4 (3) | 1 (3) |
| Complex skull fracture, basilar skull fracture or occipital condyle fracture | 20 (3) | 5 (3) | 8 (3) |
| Severe traumatic brain injury with GCS score < 6 | 25 (3) | 2 (3) | 12 (3) |
| Cervical spine fracture, subluxation or ligamentous injury at any level | 44 (3) | 6 (3) | 44 (3) |
| Clothesline-type injury or seat belt abrasion with significant swelling, pain or altered level of consciousness | 3 (3) | 2 (3) | 0 (0) |
| Scalp degloving | 3 (3) | 0 (0) | 1 (3) |
| Thoracic vascular injury | 22 (3) | 8 (3) | 7 (3) |
| Upper rib fracture | 24 (3) | 5 (3) | 9 (3) |
BCVI = blunt cerebrovascular injury; CT = computed tomography; GCS = Glasgow Coma Scale; MRI = magnetic resonance imaging; TIA = transient ischemic attack.