Blunt Cerebrovascular Injury (BCVI) can be difficult to diagnose and potentially devastating to miss because of the risk of a potential ischemic stroke. The most recent (2010) Eastern Association for the Surgery of Trauma (EAST) guidelines reviewed 68 journal publications to create the following recommendations based on the best available evidence.1 We summarize the imaging and management recommendations most pertinent to the ED as an infographic for quick and easy reference.1,2 Of note: an isolated neck seat belt sign is NOT an indication for imaging!

Guideline Review: Blunt Cerebrovascular Injury

blunt cerebrovascular injury guideline EAST


  1. Bromberg W, Collier B, Diebel L, et al. Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. J Trauma. 2010;68(2):471-477.
  2. Biffl W, Cothren C, Moore E, et al. Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries. J Trauma. 2009;67(6):1150-1153.
Kelly Wong, MD

Kelly Wong, MD

ALiEM Guidelines Editor
Emergency Medicine Resident
Department of Emergency Medicine
Brown Alpert Medical School