{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:56:59Z","timestamp":1790139419689,"version":"4.0.1"},"reference-count":43,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2020,5]]},"DOI":"10.1016\/j.wneu.2020.01.191","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T11:54:00Z","timestamp":1580730840000},"page":"e315-e320","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"special_numbering":"C","title":["Predictors of Cervical Vertebral and Carotid Artery Dissection During Blunt Trauma: Experience From a Level 1 Trauma Center"],"prefix":"10.1016","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1485-451X","authenticated-orcid":false,"given":"Allen L.","family":"Ho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayantan","family":"Deb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9272-019X","authenticated-orcid":false,"given":"Lily H.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshul","family":"Haldipur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harminder","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2020.01.191_bib1","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1089\/neu.2013.3309","article-title":"Incidence and trends in the diagnosis of traumatic extracranial cerebrovascular injury in the nationwide inpatient sample database, 2003\u20132010","volume":"31","author":"Harrigan","year":"2014","journal-title":"J\u00a0Neurotrauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib2","first-page":"308","article-title":"Liberalized screening for blunt carotid and vertebral artery injuries is justified","volume":"51","author":"Kerwin","year":"2001","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib3","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.amjsurg.2011.06.033","article-title":"Incidence of blunt cerebrovascular injury in low-risk cervical spine fractures","volume":"202","author":"Kopelman","year":"2011","journal-title":"Am J Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib4","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/00000658-200209000-00015","article-title":"Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes","volume":"236","author":"Miller","year":"2002","journal-title":"Ann Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib5","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/00000658-200005000-00007","article-title":"The devastating potential of blunt vertebral arterial injuries","volume":"231","author":"Biffl","year":"2000","journal-title":"Ann Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib6","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\u00a0Trauma Acute Care Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib7","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1227\/NEU.0b013e31821a8701","article-title":"Incidence of blunt craniocervical artery injuries: use of whole-body computed tomography trauma imaging with adapted computed tomography angiography","volume":"69","author":"Fleck","year":"2011","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2020.01.191_bib8","first-page":"450","article-title":"Clinical and radiological outcomes following traumatic grade 1 and 2 vertebral artery injuries: a 10-year retrospective analysis from a level 1 trauma center","volume":"121","author":"Scott","year":"2014","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.191_bib9","doi-asserted-by":"crossref","first-page":"490","DOI":"10.3171\/2015.6.SPINE15140","article-title":"Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a level I trauma center","volume":"24","author":"Lockwood","year":"2016","journal-title":"J\u00a0Neurosurg Spine"},{"key":"10.1016\/j.wneu.2020.01.191_bib10","first-page":"845","article-title":"Blunt carotid arterial injuries: implications of a new grading scale","volume":"47","author":"Biffl","year":"1999","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib11","doi-asserted-by":"crossref","first-page":"E72","DOI":"10.1177\/000313481107700406","article-title":"Vertebral artery injury after blunt trauma without concomitant cervical or neurologic injuries: a screening conundrum","volume":"77","author":"Kopriva","year":"2011","journal-title":"Am Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib12","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.jvs.2012.09.006","article-title":"Contemporary outcomes of vertebral artery injury","volume":"57","author":"Alterman","year":"2013","journal-title":"J\u00a0Vasc Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib13","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.wneu.2012.04.029","article-title":"Clinical outcome after vertebral artery injury following blunt cervical spine trauma","volume":"80","author":"Mitha","year":"2013","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.191_bib14","first-page":"829","article-title":"The efficacy of a two-tiered trauma activation system at a level I trauma center","volume":"67","author":"Kouzminova","year":"2009","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib15","first-page":"1204","article-title":"Sixteen-slice multi-detector computed tomographic angiography improves the accuracy of screening for blunt cerebrovascular injury","volume":"60","author":"Berne","year":"2006","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib16","first-page":"745","article-title":"Sixteen-slice computed tomographic angiography is a reliable noninvasive screening test for clinically significant blunt cerebrovascular injuries","volume":"60","author":"Biffl","year":"2006","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib17","first-page":"551","article-title":"CTA-based screening reduces time to diagnosis and stroke rate in blunt cervical vascular injury","volume":"67","author":"Eastman","year":"2009","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1053\/j.sult.2007.01.009","article-title":"Screening for blunt cerebrovascular injuries: the essential role of computed tomography angiography","volume":"28","author":"Stengel","year":"2007","journal-title":"Semin Ultrasound CT MR"},{"key":"10.1016\/j.wneu.2020.01.191_bib19","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.suc.2010.10.004","article-title":"Imaging for blunt carotid and vertebral artery injuries","volume":"91","author":"Burlew","year":"2011","journal-title":"Surg Clin North Am"},{"key":"10.1016\/j.wneu.2020.01.191_bib20","first-page":"475","article-title":"Routinely repeated computed tomography after blunt head trauma: does it benefit patients?","volume":"56","author":"Kaups","year":"2004","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib21","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1001\/archsurg.139.5.540","article-title":"Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate","volume":"139","author":"Cothren","year":"2004","journal-title":"Arch Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib22","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S1072-7515(01)00772-4","article-title":"The high morbidity of blunt cerebrovascular injury in an unscreened population: more evidence of the need for mandatory screening protocols","volume":"192","author":"Berne","year":"2001","journal-title":"J\u00a0Am Coll Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib23","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jvs.2009.08.071","article-title":"A\u00a0multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury","volume":"51","author":"Berne","year":"2010","journal-title":"J\u00a0Vasc Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib24","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1055\/s-0036-1579552","article-title":"Blunt cerebrovascular injury in cervical spine fractures: are more-liberal screening criteria warranted?","volume":"6","author":"Grabowski","year":"2016","journal-title":"Glob Spine J"},{"key":"10.1016\/j.wneu.2020.01.191_bib25","first-page":"691","article-title":"Blunt cerebrovascular injury screening guidelines: what are we willing to miss?","volume":"76","author":"Bruns","year":"2014","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib26","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1007\/s00586-011-2009-x","article-title":"Blunt cerebrovascular injuries in acute trauma care: a screening protocol","volume":"21","author":"L\u00f6hrer","year":"2012","journal-title":"Eur Spine J"},{"key":"10.1016\/j.wneu.2020.01.191_bib27","first-page":"1058","article-title":"Improving the screening criteria for blunt cerebrovascular injury: the appropriate role for computed tomography angiography","volume":"70","author":"Emmett","year":"2011","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib28","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\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib29","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"},{"key":"10.1016\/j.wneu.2020.01.191_bib30","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/SLA.0b013e3181568cab","article-title":"Computed tomographic angiography for the diagnosis of blunt carotid\/vertebral artery injury","volume":"246","author":"Malhotra","year":"2007","journal-title":"Ann Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib31","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.annemergmed.2017.07.006","article-title":"Cost-effectiveness of magnetic resonance imaging in cervical spine clearance of neurologically intact patients with blunt trauma","volume":"71","author":"Wu","year":"2018","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.wneu.2020.01.191_bib32","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1097\/BRS.0b013e318294bacb","article-title":"Vertebral artery injury associated with blunt cervical spine trauma: a multivariate regression analysis","volume":"38","author":"Lebl","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.wneu.2020.01.191_bib33","first-page":"217","article-title":"Blunt vertebral vascular injury in trauma patients: ATLS\u00ae recommendations and review of current evidence","volume":"3","author":"Shafafy","year":"2017","journal-title":"J\u00a0Spine Surg (Hong Kong)"},{"key":"10.1016\/j.wneu.2020.01.191_bib34","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s00330-015-3858-1","article-title":"Association between cervical spine and skull-base fractures and blunt cerebrovascular injury","volume":"26","author":"Buch","year":"2016","journal-title":"Eur Radiol"},{"key":"10.1016\/j.wneu.2020.01.191_bib35","first-page":"1033","article-title":"Clinical utility of a screening protocol for blunt cerebrovascular injury using computed tomography angiography","volume":"126","author":"Tso","year":"2017","journal-title":"J\u00a0Neurosurg"},{"key":"10.1016\/j.wneu.2020.01.191_bib36","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.jamcollsurg.2011.11.012","article-title":"A\u00a0systematic review and meta-analysis of diagnostic screening criteria for blunt cerebrovascular injuries","volume":"214","author":"Franz","year":"2012","journal-title":"J\u00a0Am Coll Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib37","doi-asserted-by":"crossref","first-page":"379","DOI":"10.2176\/nmc.oa.2013-0135","article-title":"Factors associated with blunt cerebrovascular injury in patients with cervical spine injury","volume":"54","author":"Nakajima","year":"2014","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.1016\/j.wneu.2020.01.191_bib38","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1017\/S0317167100010726","article-title":"Blunt cerebrovascular injuries: diagnosis and management outcomes","volume":"37","author":"Wei","year":"2010","journal-title":"Can J Neurol Sci"},{"key":"10.1016\/j.wneu.2020.01.191_bib39","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1749-7922-5-17","article-title":"Evaluation of the criteria for angiotomography indications in the diagnosis of carotid and vertebral arterial injury associated with blunt trauma","volume":"5","author":"Gladstone","year":"2010","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib40","first-page":"811","article-title":"Cervical spine fracture patterns predictive of blunt vertebral artery injury","volume":"55","author":"Cothren","year":"2003","journal-title":"J\u00a0Trauma"},{"key":"10.1016\/j.wneu.2020.01.191_bib41","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13017-015-0040-7","article-title":"The limitations of using risk factors to screen for blunt cerebrovascular injuries: the harder you look, the more you find","volume":"10","author":"Jacobson","year":"2015","journal-title":"World J Emerg Surg"},{"key":"10.1016\/j.wneu.2020.01.191_bib42","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/00007632-199701150-00011","article-title":"Vertebral artery occlusion associated with cervical spine trauma: a prospective analysis","volume":"22","author":"Giacobetti","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.wneu.2020.01.191_bib43","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1111\/ans.12439","article-title":"Denver screening protocol for blunt cerebrovascular injury reduces the use of multi-detector computed tomography angiography","volume":"84","author":"Beliaev","year":"2014","journal-title":"ANZ J Surg"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875020302096?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875020302096?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T08:41:33Z","timestamp":1761813693000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875020302096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":43,"alternative-id":["S1878875020302096"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2020.01.191","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2020,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Predictors of Cervical Vertebral and Carotid Artery Dissection During Blunt Trauma: Experience From a Level 1 Trauma Center","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2020.01.191","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2020 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}