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Table 1: The expanded Denver criteria^{^a}
Signs/Symptoms Risk Factors
Potential arterial hemorrhage from face or neck High-energy trauma mechanism with:
Cervical bruit in patient <50 yr LeFort II or III facial fracture
Expanding cervical hematoma Mandible fracture
Neurologic deficit inconsistent with head CT Complex skull or skull base fracture
Stroke on CT or MRI Severe TBI with GCS < 6
Cervical spine fracture, subluxation, or ligamentous injury at any level
Near hanging with anoxic brain injury
Clothesline type injury or seat belt abrasion with significant swelling, pain, or altered mental status
TBI with thoracic injuries
Scalp degloving
Thoracic vascular injury
Blunt cardiac rupture
Upper rib fractures
Note:—TBI indicates traumatic brain injury; GCS, Glasgow Coma Scale.
↵a Adapted from Nagpal et al.³⁷

Signs/Symptoms	Risk Factors
Potential arterial hemorrhage from face or neck	High-energy trauma mechanism with:
Cervical bruit in patient <50 yr	LeFort II or III facial fracture
Expanding cervical hematoma	Mandible fracture
Neurologic deficit inconsistent with head CT	Complex skull or skull base fracture
Stroke on CT or MRI	Severe TBI with GCS < 6
	Cervical spine fracture, subluxation, or ligamentous injury at any level
	Near hanging with anoxic brain injury
	Clothesline type injury or seat belt abrasion with significant swelling, pain, or altered mental status
	TBI with thoracic injuries
	Scalp degloving
	Thoracic vascular injury
	Blunt cardiac rupture
	Upper rib fractures