{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:09:46Z","timestamp":1791266986063,"version":"4.1.0"},"reference-count":33,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"am","delay-in-days":343,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000057","name":"NIH National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["americanjournalofsurgery.com","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Surgery"],"published-print":{"date-parts":[[2025,10]]},"DOI":"10.1016\/j.amjsurg.2025.116480","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T02:36:04Z","timestamp":1749609364000},"page":"116480","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["A blunt look at stroke risk in BCVI: Do multiple injuries increase the risk of stroke?"],"prefix":"10.1016","volume":"248","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6287-9078","authenticated-orcid":false,"given":"Victoria","family":"Wagner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua D.","family":"Preston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"De Leon Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronnie W.","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Garcia-Toca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Benjamin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Rob","family":"Todd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D.","family":"Sciarretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.amjsurg.2025.116480_bib1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00068-019-01171-9","article-title":"Blunt cerebrovascular injury: incidence and long-term follow-up","volume":"47","author":"Hundersmarck","year":"2021","journal-title":"Eur J Trauma Emerg Surg"},{"issue":"7","key":"10.1016\/j.amjsurg.2025.116480_bib2","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.1007\/s00268-017-4408-6","article-title":"Blunt cerebrovascular artery injury and stroke in severely injured patients: an international multicenter analysis","volume":"42","author":"Weber","year":"2018","journal-title":"World J Surg"},{"issue":"3","key":"10.1016\/j.amjsurg.2025.116480_bib3","doi-asserted-by":"crossref","DOI":"10.1016\/j.injury.2024.111319","article-title":"Prognostic factors associated with risk of stroke following blunt cerebrovascular injury: a systematic review and meta-analysis","volume":"55","author":"Tran","year":"2024","journal-title":"Injury"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116480_bib4","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/TA.0000000000003455","article-title":"Factors associated with stroke formation in blunt cerebrovascular injury: an EAST multicenter study","volume":"92","author":"Esposito","year":"2022","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"10.1016\/j.amjsurg.2025.116480_bib5","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/00000658-199810000-00003","article-title":"The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome","volume":"228","author":"Biffl","year":"1998","journal-title":"Ann Surg"},{"issue":"1","key":"10.1016\/j.amjsurg.2025.116480_bib6","doi-asserted-by":"crossref","DOI":"10.1186\/s13049-018-0559-1","article-title":"Best practice guidelines for blunt cerebrovascular injury (BCVI)","volume":"26","author":"Brommeland","year":"2018","journal-title":"Scand J Trauma Resuscitation Emerg Med"},{"issue":"4","key":"10.1016\/j.amjsurg.2025.116480_bib7","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1097\/TA.0b013e318287800f","article-title":"Functional outcomes following blunt cerebrovascular injury","volume":"74","author":"DiCocco","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"issue":"4","key":"10.1016\/j.amjsurg.2025.116480_bib8","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1177\/000313481808400430","article-title":"Long-Term functional outcomes after blunt cerebrovascular injury: a 20-year experience","volume":"84","author":"Shahan","year":"2018","journal-title":"Am Surg"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116480_bib9","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1097\/00000658-199605000-00007","article-title":"Blunt carotid injury: importance of early diagnosis and anticoagulant therapy","volume":"223","author":"Fabian","year":"1996","journal-title":"Ann Surg"},{"issue":"12","key":"10.1016\/j.amjsurg.2025.116480_bib10","doi-asserted-by":"crossref","DOI":"10.1007\/s11910-018-0906-7","article-title":"Management of blunt cerebrovascular injury","volume":"18","author":"Stone","year":"2018","journal-title":"Curr Neurol Neurosci Rep"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116480_bib11","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1097\/00005373-199911000-00004","article-title":"Blunt carotid arterial injuries: implications of a new grading scale","volume":"47","author":"Biffl","year":"1999","journal-title":"J Trauma"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116480_bib12","first-page":"471","article-title":"Blunt cerebrovascular injury practice management guidelines: the eastern association for the surgery of trauma","volume":"68","author":"Bromberg","year":"2010","journal-title":"J Trauma Inj Infect Crit Care"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116480_bib13","first-page":"1150","article-title":"Western trauma association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries","volume":"67","author":"Biffl","year":"2009","journal-title":"J Trauma Inj Infect Crit Care"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116480_bib14","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1016\/j.amjsurg.2016.09.016","article-title":"Expanded screening criteria for blunt cerebrovascular injury: a bigger impact than anticipated","volume":"212","author":"Geddes","year":"2016","journal-title":"Am J Surg"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116480_bib15","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/TA.0000000000003010","article-title":"Universal screening for blunt cerebrovascular injury","volume":"90","author":"Black","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116480_bib16","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1097\/TA.0000000000002824","article-title":"Blunt cerebrovascular injury: the case for universal screening","volume":"89","author":"Leichtle","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"10.1016\/j.amjsurg.2025.116480_bib17","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.jvs.2024.04.053","article-title":"The role of number of affected vessels on radiologic and clinical outcomes of patients with blunt cerebrovascular injury","volume":"80","author":"Hosseinpour","year":"2024","journal-title":"J Vasc Surg"},{"issue":"3","key":"10.1016\/j.amjsurg.2025.116480_bib18","first-page":"425","article-title":"Segments of the internal carotid artery: a new classification","volume":"38","author":"Bouthillier","year":"1996","journal-title":"Neurosurgery"},{"key":"10.1016\/j.amjsurg.2025.116480_bib20","author":"Ripley"},{"issue":"77","key":"10.1016\/j.amjsurg.2025.116480_bib21","article-title":"pROC: an open-source package for R and S+ to analyze and compare ROC curves","volume":"12","author":"Robin","year":"2011","journal-title":"BMC Bioinformatics"},{"key":"10.1016\/j.amjsurg.2025.116480_bib22","series-title":"Ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"},{"key":"10.1016\/j.amjsurg.2025.116480_bib23","author":"Brunson"},{"issue":"8","key":"10.1016\/j.amjsurg.2025.116480_bib25","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1097\/00005373-199008000-00003","article-title":"Carotid artery trauma: management based on mechanism of injury","volume":"30","author":"Fabian","year":"1990","journal-title":"J Trauma"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116480_bib26","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1067\/mva.1991.32076","article-title":"Blunt trauma to the carotid arteries","volume":"14","author":"Martin","year":"1991","journal-title":"J Vasc Surg"},{"issue":"7","key":"10.1016\/j.amjsurg.2025.116480_bib27","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/S0011-3840(99)80807-7","article-title":"Blunt cerebrovascular injuries","volume":"36","author":"Biffl","year":"1999","journal-title":"Curr Probl Surg"},{"issue":"4","key":"10.1016\/j.amjsurg.2025.116480_bib28","doi-asserted-by":"crossref","DOI":"10.1016\/j.injury.2024.111485","article-title":"Antiplatelets versus anticoagulants in the treatment of blunt cerebrovascular injury (BCVI) \u2013 a systematic review and meta-analysis","volume":"55","author":"Momic","year":"2024","journal-title":"Injury"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116480_bib29","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.3171\/2020.10.JNS201836","article-title":"Aspirin versus anticoagulation for stroke prophylaxis in blunt cerebrovascular injury: a propensity-matched retrospective cohort study","volume":"135","author":"Bonow","year":"2021","journal-title":"J Neurosurg"},{"issue":"1","key":"10.1016\/j.amjsurg.2025.116480_bib30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/TA.0000000000004439","article-title":"Diagnosis and management of blunt cerebrovascular injuries: what you need to know","volume":"98","author":"Biffl","year":"2025","journal-title":"J Trauma Acute Care Surg"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116480_bib31","doi-asserted-by":"crossref","first-page":"522","DOI":"10.3171\/2023.5.JNS222818","article-title":"Traumatic vertebral artery injury: Denver grade, bilaterality, and stroke risk. A systematic review and meta-analysis","volume":"140","author":"Michalopoulos","year":"2024","journal-title":"J Neurosurg"},{"key":"10.1016\/j.amjsurg.2025.116480_bib32","article-title":"Management patterns and outcomes after traumatic brain injury with associated blunt cerebrovascular injury","author":"Findlay","year":"2023","journal-title":"Neurosurgery"},{"issue":"2","key":"10.1016\/j.amjsurg.2025.116480_bib33","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1148\/radiol.2020192866","article-title":"Natural history of blunt cerebrovascular injury: experience over a 10-year period at a level I trauma center","volume":"297","author":"Wu","year":"2020","journal-title":"Radiology"},{"issue":"6","key":"10.1016\/j.amjsurg.2025.116480_bib34","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1097\/TA.0000000000003127","article-title":"Blunt cerebrovascular injuries: outcomes from the American association for the surgery of trauma PROspective observational vascular injury treatment (PROOVIT) multicenter registry","volume":"90","author":"Russo","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"10.1016\/j.amjsurg.2025.116480_bib35","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/00000658-200205000-00012","article-title":"Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography","volume":"235","author":"Biffl","year":"2002","journal-title":"Ann Surg"}],"container-title":["The American Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961025003034?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002961025003034?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T01:05:32Z","timestamp":1757379932000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002961025003034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":33,"alternative-id":["S0002961025003034"],"URL":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116480","relation":{},"ISSN":["0002-9610"],"issn-type":[{"value":"0002-9610","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A blunt look at stroke risk in BCVI: Do multiple injuries increase the risk of stroke?","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjsurg.2025.116480","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"116480"}}