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["Appendix 2"]
["Main author, et al.","Year","Title","Journal","Main findings"]
["Alterman, DM",2013,"Contemporary outcomes of vertebral artery injury","J Vasc Surg 57(3): 741-746 ","51 cases of VAI in 36942 trauma cases (0.13% incidence) . Medical treatment in nearly all cases. Stroke rate 1.9%. 88% of patients had cervical fractures."]
["Azarakhsh, N",2013,"Blunt cerebrovascular injuries in children:Underreported or underdiagnosed? A multicenter ATOMAC study","J Trauma Acute Care Surg 75(6):1006-1012","5828 pediatric blunt traumas, stroke rate 23%. No strokes among treated patients, 2 of 12 untreated developed stroke."]
["Beliaev, AM",2013,"Denver screening protocol for blunt cerebrovascular injury reduces the use of multi-detector computed tomography angiography","ANZ Journal of Surgery 84(6):429-32","The Denver protocol applied to patient population had a sensitivity of 97% and specificity of 42%.  "]
["Berne, JD",2006,"Sixteen-slice multi-detector computed tomographic angiography improves the accuracy of screening for blunt cerebrovascular injury","J Trauma Inj Inf Crit Care 60(6): 1204-1209","The detected incidence of BCVI increased more than threefold with the 16-slice scanner when compared with the four-slice scanner."]
["Berne, JD",2009,"Blunt vertebral artery injuries in the era of computed tomographic angiographic screening: incidence and outcomes from 8,292 patients","J Trauma Inj Inf Crit Care 67(6): 1333-1338","Using aggressive screening and individualized treatment protocol for BVI, very few potentially preventable BVI-related strokes and deaths were seen."]
["Berne, JD",2010,"A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury","J Vasc Surg 51(1): 57-64","Independent predictors of BCVI were cervical spine injury, mandible fracture, basilar skull fracture, injury severity score (ISS) and GCS."]
["Biffl, WL",2009,"Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries","J Trauma Inj Inf Crit Care 67(6): 1150-1153","Non-systematic review with clinical recommendations for screening, treatment and follow-up."]
["Bromberg, WJ",2010,"Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma.","J Trauma Inj Inf Crit Care 68(2): 471-477","Systematic review."]
["Buch, K",2016,"Association between cervical spine and skull-base fractures and blunt cerebrovascular injury","J Eur Radiol 26(2):524-531","46 its of 432 screened with 64-slice CT had BCVI. Any cervical fracture associated with BCVI."]
["Burlew, CC",2012,"Blunt cerebrovascular injuries: Redefining screening criteria in the era of noninvasive diagnosis"," J Trauma Acut Care Surg 72:330-337","A significant number of patients suffering BCVI are not captured by current screening guidelines."]
["Burlew, CC",2014,"Endovascular stenting is rarely necessary for the management of blunt cerebrovascular injuries","J Am Coll Surg 218(5):1012-1017","Antithrombotic treatment for BCVI is effective for stroke prevention. Endovascular procedures do not appear to provide additional benefit. "]
["Calcutt, RA",2012,"Early treatment of blunt cerebrovascular injury with concomitant hemorrhagic neurologic injury is safe and effective","J Trauma 72:338-346","77 patients with TBI and BCVI studied. Early treatment (day 3) safe and reduces stroke rate from 57% to 4%."]
["Chamoun, RB",2008,"Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options","J Neurosurg Pediatr 2(2): 101-108","Systematic review."]
["Chen, PR",2016,"Efficacy of a self-expandable porous stent as the sole curative treatment for extracranial carotid pseudoaneurysms","World Neurosurg 88: 333-341","Prospective cohort study of 14 patients with grade III injury, no major complications."]
["Ciapetti, M",2010,"Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria","Scand J Trauma Resusc Emerg Med 18: 1-5","Addition of petrous bone skull fracture to original Memphis criteria improved the CTA yield."]
["Cook, M",2017,"A cohort study of blunt cerebrovascular injury screening in children: Are they just little adults?","J Trauma Acute Care Surg (84): 50-57","BCVI rate 1.3%, median age 16 yrs. Stroke rate 18%. Denver criteria best in predicting BCVI. Stroke rate similar between anti- platelet and no treatment."]
["Cothren, CC",2007,"Cervical spine fracture patterns mandating screening to rule out blunt cerebrovascular injury","Surgery 141(1): 76-82","BCVI is associated with complex cervical spine fractures."]
["Crawford, JD",2015,"The natural history of indeterminate blunt cerebrovascular injury","JAMA Surgery 150(9): 841-847","Repeat imaging valuable as 25% of iBCVI true BCVI, 39% resolved, 35.6% remained iBCVI."]
["Daou, B",2017,"Anticoagulation vs antiplatelet treatment in patients with carotid and vertebral artery dissection: A study of 370 patients and literature review","Neurosurgery 80:368-379","Antiplatetelet and anticoagulation is similar in stoke prevention in patients with spontaneous and traumatic BCVI."]
["deSouza, RM",2011,"Blunt traumatic vertebral artery injury: a clinical review","Eur Spine J 20(9): 1405-1416","Systematic review."]
["Ding, T",2010,"Correlation of C2 fractures and vertebral artery injury.","Spine 35(12): E520-524","Vertebral artery injuries are more likely to occur in C2 fractures with comminuted fractures involving the foramen transversarium."]
["DuBose, J",2008,"Endovascular stenting for the treatment of traumatic internal carotid injuries: expanding experience","J Trauma Inj Inf Crit Care 65(6): 1561-1566","Systematic review."]
["Durand, D","2015","Predictors of vertebral artery injury in isolated C2 fractures based on fracture morphology using CT angiography","Spine 40(12): E713-718","The C2 fracture pattern most associated with VAI was comminuted transverse foramen fracture with intraforaminal fragments."]
["Eastman, AL",2006,"Computed tomographic angiography for the diagnosis of blunt cervical vascular injury: is it ready for primetime?","J Trauma Inj Inf Crit Care 60(5): 925-929","CTA, using a 16-channel detector, can be used to accurately screen at-risk patients for BCVI."]
["Eastman, AL",2009,"CTA-based screening reduces time to diagnosis and stroke rate in blunt cervical vascular injury","J Trauma Inj Inf Crit Care 67(3): 551-556","CTA reduces time to diagnosis from 31 hrs to 2.6 hrs when using DSA. Stroke rate reduced from 15% to 3.8%."]
["Edwards, NM",2007,"Antithrombotic therapy and endovascular stents are effective treatment for blunt carotid injuries: results from longterm followup","J Am Coll Surg 204(5): 1007-1013","Antiplatelet and anticoagulation therapy are equally effective in preventing stroke. Carotid stents appear to be safe and effective for lesions that develop pseudoaneurysms or extensive dissections."]
["Emmett, K",2011,"Improving the screening criteria for blunt cerebrovascular injury: The appropriate role for computed tomography angiography","J Trauma 70:1058-1065","The conventional screening criteria identify most patients with BCVI (84%). CTA as a screening criterion captures nearly all remaining patients. Angiography remains gold standard."]
["Esnault, P",2017,"Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors and evolution","J Neurosurg 127:16-22","Blunt cerebrovascular injuries are frequent after severe TBI (incidence 9.2%).Treatment started 1.5 days and safe."]
["Fassett, DR",2008,"Vertebral artery injuries associated with cervical spine injuries: a review of the literature.","J Spinal Disord Tech 21(4): 252-258","Systematic review."]
["Foreman, PM",2016,"Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography","J Neurosurg 127:32-35","Grading of TCVI with CTA using the Biffl scale is reliable. "]
["Franz, RW",2010,"Postdischarge outcomes of blunt cerebrovascular injuries","Vasc Endovascular Surg 44(3): 198-211","Outcomes after BCVI in 29 patients. Sixteen (84.2%) BCVIs resolved. Anticoagulation and antiplatelet therapies were equally effective."]
["Franz, RW",2012,"A systematic review and meta-analysis of diagnostic screening criteria for blunt cerebrovascular injuries","J Am Coll Surg 214:313-327","Patients with cervical spine and thoracic injuries had significantly greater likelihoods of BCVI compared with patients without these injuries.\n"]
["Geddes, AE.",2016,"Expanded screening criteria for blunt cerebrovascular injury: a bigger impact than anticipated","Am J Surg 212:1167-1174","There was a significant increase in the identification of BCVI following the adoption of expanded screening criteria, resulting in a substantial reduction of missed injuries. \n"]
["Goodwin, RB",2009,"Computed tomographic angiography versus conventional angiography for the diagnosis of blunt cerebrovascular injury in trauma patients","J Trauma Inj Inf Crit Care 67(5): 1046-1050","Neither 16 -nor 64-slice CTA is as accurate as CA as a screening tool for BCVI. "]
["Harrigan, MR",2013,"Management of vertebral artery injuries following non-penetrating cervical trauma","Neurosurgery 72 Suppl 2: 234-243","Systematic review."]
["Herbert, JP",2018,"Pediatric blunt cerebrovascular injury:The McGovern screening score","J Neurosurg Pediatr 16:1-11","Standard screening criteria did not accurately predict BCVI. The McGovern score incorporates the mechanism of injury."]
["Herrera, DA",2008,"Endovascular treatment of traumatic injuries of the vertebral artery","AJNR Am J Neuroradiol 29(8):1585-1589","Endovascular techniques were a safe and effective method of treatment and were not associated with significant morbidity or mortality."]
["Hoit, DA.",2008,"Angiographic detection of carotid and vertebral injury in the high-energy blunt trauma patient","J Spinal Disord Tech 21(4):259-266","Cerebral angiography in a selected group of trauma patients was found to yield a significant rate of arterial injury."]
["Jones, TS.","2012","Blunt cerebrovascular injuries in the child","Am J Surg 204(1): 7-10","More than 2/3 of pediatric patients presenting with stroke did not have screening indications according to adult protocols."]
["Kopelman, TR","2011","Risk factors for blunt cerebrovascular injury in children: Do they mimic those seen in adults?","J Trauma 71: 559-564","Risk factors for BCVI similar for adults and pediatric patients."]
["Kopelman, TR","2011","Incidence of blunt cerebrovascular injury in low-risk cervical spine fractures","Am J Surg 202(6): 684-688","All cervical spinal fracture patterns warrant screening for BCVI. "]
["Lauerman, MH","2015","Lethal now or lethal later: The natural history of Grade 4 blunt cerebrovascular injury","J Trauma Acute Care Surg 78(6): 1071-1074","The use of endovascular vessel occlusion should be considered in those patients with BCVI grade IV and true contraindications to anticoagulation. "]
["Lebl, DR","2013","Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis","Spine 38(16): 1352-1361","VAI associated with blunt cervical spine injury is a marker for more severely injured patients."]
["Lockwood, MM","2016","Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I trauma center","J Neurosurg Spine 24(3): 490-495","High-risk fractures defined by Denver criteria, VAI, and antiplatelet treatment of VAI were not independent predictors of stroke. Cost-effective screening must be reevaluated in the setting of blunt cervical spine fractures on a case-by-case basis."]
["Löhrer, L","2012","Blunt cerebrovascular injury in the trauma care: a screening protocol","Eur Spine J (2012) 21:837–843 ","Developed own screening protocol based on Denver and Memphis criteria. Tested in blunt trauma patients. 16 pts with BCVI. Early treatment safe. No strokes."]
["Malhotra, AK","2007","Computed tomographic angiography for the diagnosis of blunt carotid/vertebral artery injury: a note of caution.","Ann Surg 246(4): 632-642","Current CTA technology (16-detector) cannot reliably diagnose or exclude BCVI. Twenty percent of CTAs are either non-evaluable or suboptimal."]
["Malhotra, AK","2015","Screening for pediatric blunt cerebrovascular Injury: Review of literature and a cost-effectiveness analysis","J Pediatr Surg 50(10): 1751-1757","Systematic review."]
["Malhotra, AK","2016","Evaluation for blunt cerebrovascular injury: Review of the literature and a cost-effectiveness analysis","AJRN Am J Neuroradiol 37(2): 330-335","Selective anticoagulation based on CTA in high-risk patients most cost-effective."]
["McKinney, A","2007","Angiographic frequency of blunt cerebrovascular injury in patients with carotid canal or vertebral foramen fractures on multidetector CT","Eur J Radiol 62(3): 385-393","There is a high rate of BCVI in the presence of carotid canal or vertebral foramen fractures that are noted by multidetector CT."]
["McNutt, MK","2018","Management of blunt cerebrovascular injury (BCVI) in the multisystem injury patient with contraindications to immediate anti-thrombotic therapy","Injury 49:67-74","Compares BCVI patients with and without solid organ injury. No difference in stroke rates or bleeding complications.TBI, solid organ injury, and spinal cord injury are not contraindications to anti-thrombotic therapy."]
["Mei, Q","2014","Individualized endovascular treatment of high-grade traumatic vertebral artery injury","Acta Neurochir 156:181-1788","Application of individualized endovascular therapy in high-grade TVAI is safe, technically feasible and clinically efficient."]
["Mueller, CA","2011","Vertebral artery injuries following cervical spine trauma: a prospective observational study","Eur Spine J 20(12): 2202-2209","69 of 599 patients had cervical spine injury suspicious for VAI. VAI were identiﬁed by DSA in 27.5%. Despite anticoagulation therapy, 5.8% became clinically symptomatic and 2.9% died due to cerebrovascular ischemia."]
["Mundinger, GS","2013","Blunt-mechanism facial fracture patterns associated with internal carotid artery injuries: recommendations for additional screening criteria based on analysis of 4,398 patients","J Maxillofac Oral Surg 71(12): 2092-2100","Specific facial fracture patterns confer increased risk of BCAI, especially in association with\nbasilar skull fractures."]
["Nagpal, P","2017","Blunt cerebrovascular Injuries: advances in screening, imaging, and management trends","AJNR. Am J Neuroradiol 75:543-549","Non-systematic review of imaging and treatment options."]
["Pandey, AS","2015","Management of pediatric craniocervical arterial dissections","Childs Nerv Syst 31(1): 101-107","BCVI is commonly related to trauma and presents with stroke. The majority of patients experience good clinical outcome. Recanalization of initial vessel occlusion occurs in half of cases at 2 years."]
["Paulus, EM","2014","Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it","J Trauma Acute Care Surg 76(2): 279-284","Benefit and cost related to DSA suggests that CTA is modality of choice."]
["Payabvash, S","2014","Screening and detection of blunt vertebral artery injury in patients with upper cervical fractures: the role of cervical CT and CT angiography","Eur J Radiol 83(3): 571-577","210 patients with C1 and/or C2 fractures screened with CTA. C1 and C2 fractures alone not necessarily indications for CTA."]
["Rao, AS","2011","Long-term outcomes of internal carotid artery dissection","J Vasc Surg 54: 370-375","Most cervical carotid dissections can safely be conservatively managed, with the majority achieving anatomic and symptomatic resolution.\n"]
["Ravindra, VM","2015","Risk factors for traumatic blunt cerebrovascular injury diagnosed by computed tomography angiography in the pediatric population: a retrospective cohort study","J Neurosurg Pediatr:15(6):599-606","Utah screening criterias for children developed based on 234 patients with a total of 36 patients with BCVI."]
["Ravindra VM","2017","Predicting blunt cerebrovascular injury in pediatric trauma: Validation of the “Utah Score”","J Neurotrauma 34:391-399","Extermal validation of the Utah score: risk assessment and screening criteria for pediatric patients. Denver criteria seem to overestimate the risk of BCVI in children."]
["Roberts, DJ","2013","Diagnostic accuracy of computed tomographic angiography for blunt cerebrovascular injury detection in trauma patients: a systematic review and meta-analysis","Ann Surg 257(4): 621-632","Systematic review.\n"]
["Schico, A","2018","Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram  as a mandatory scan component in severely injured patients","Ther Clin Risk Manag 14: 173–178\n","Prospective study of 230 severely injured patients. CTA showed BCVI in 6.5% of cases. CAI>VAI. Mortality rate 25%."]
["Schneidereit, NP","2006","Utility of screening for blunt vascular neck injuries with computed tomographic angiography","J Trauma Inj Infect Crit Care 60(1): 209-215","CTA screening increases the detected incidence of BCVI 8-fold, with rates similar to angiographically based screening protocols."]
["Sinnathamby, M","2018","Increased detection of blunt carotid and vertebral artery injury after implementation of diagnostic imaging pathway in level 1 trauma centre in Western Australia","Injury 48:1917-1921","Incidence of BCVI in blunt trauma population increased after introduction of diagnostic screening criteria. Stroke rate reduced, but n.s."]
["Scott, WW","2015","Clinical and radiographic outcomes following traumatic Grade 1 and 2 carotid artery injuries: a 10-year retrospective analysis from a Level I trauma center. The Parkland Carotid and Vertebral Artery Injury Survey","J Neurosurg 122(5): 1196-1201","Stroke rate was 1% in low-grade BCIs cohort, The use of antiplatelet or anticoagulant medications did not correlate with radiographic injury stability, nor with a decreased rate of cerebral infarction. \n"]
["Scott, WW","2015","Clinical and radiographic outcomes following traumatic Grade 3 and 4 carotid artery injuries: a 10-year retrospective analysis from a Level 1 trauma center. The Parkland Carotid and Vertebral Artery Injury Survey","J Neurosurg 122(3): 610-615","Grade 3 and 4 BCAIs carry the highest stroke risk of the blunt cerebrovascular injuries."]
["Shafafy, R.",2017,"Blunt vertebral vascular injury in trauma patients:ATLS recommendations and review of current evidence","J Spine Surg 3(2):217-225","Systematic review."]
["Shahan, CP","2016","Early antithrombotic therapy is safe and effective in patients with blunt cerebrovascular injury and solid organ injury or traumatic brain injury","The Journal of Trauma and Acute Care Surgery 81(1):173-177","Initiation of early AT for patients with BCVI and concomitant TBI or solid organ injury (SOI) does not increase risk of worsening TBI or SOI above baseline."]
["Shahan, CP","2016","A safe and effective management strategy for blunt cerebrovascular injury: Avoiding unnecessary anticoagulation and eliminating stroke","J Trauma Acute Care Surg 80(6): 915-922","Definitive diagnosis by DSA led to avoidance of potentially harmful anticoagulation in 45% of CTA-positive patients (false-positive results)."]
["Spaniolas, K","2008","Does improved detection of blunt vertebral artery injuries lead to improved outcomes?","World J Surg 32(10): 2190-2194","As a result of increased awareness, the rate of detection of BVI has doubled in recent years."]
["Stein, DM","2009","Blunt cerebrovascular injuries: Does treatment always matter?","J Trauma 66 (1): 132-144","147 patients with BCVI with an incidence of 1.2%, mortality rate 13%, stroke rate 25.8% for untreated patients and 3.9% for treated."]
["Sun, GH","2011","Analysis of carotid artery injury in patients with basilar skull fractures","Otol Neurotol 32(5): 882-886","Skull base fractures are associated with BCI."]
["Tolhurst, SR","2013","Cervical arterial injury after blunt trauma in children: characterization and advanced imaging","J Pediatric Orthop 33(1): 37-42","BCVI is common, with a minimum incidence of 7/61 or >10% of pediatric patients with blunt cervical spine injury."]
["Tso, MK","2016","Clinical utility of a screening protocol for blunt cerebrovascular injury using computed tomography angiography","J Neurosurg126(4):1033-1041","A CTA screening protocol for BCVI may be of clinical benefit with possible reduction in ischemic complications."]
["Utter, GH","2006","Sixteen-slice CT angiography in patients with suspected blunt carotid and vertebral artery injuries","J Am Coll Surg 203(6):838-848","Multidetector CTA misses relatively few injuries and adequately supplants DSA as a screening study in patients with risk factors for BCVI. \n"]
["Wagenaar, AE","2014","Early repeat imaging is not warranted for high-grade blunt cerebrovascular injuries.","J Trauma Acute Care Surg 77(4): 540-545","Early repeat imaging may not be warranted in high-grade BCVI; the vast majority of injuries do not resolve."]
["Weber, CD","2017","Blunt cerebrovascular artery injury and stroke in severely injured patients: An international multicenter analysis","World J Surg (epub)","786 pts with BCVI (1%). Stroke rate 11.5%. BCVI-associated stroke a significant risk factor for mortality."]