Cothren et al identified cervical spine fracture patterns which justify imaging studies to exclude blunt cerebrovascular injury. Aggressive management can minimize ischemic neurologic events in patients with blunt vascular injury. The authors are from the University of Colorado in Denver.


Cervical spine fractures associated with a significant risk of blunt cerebrovascular injury:

(1) any with subluxation

(2) fracture to the body in C1, C2 and/or C3

(3) extension into the foramen transversarium (in the transverse processes of C1 to C6)



• The foramen transversarium in C7 carries the vertebral vein but not the artery.


Other fracture patterns do not require screening unless there are other reasons for screening (such as basilar skull fracture, near-hanging, diffuse axonal injury, etc.)


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