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Table 2: Boston Criteria¹⁷ for BCVI
First Tier^{^a} Second Tier^{^b}
Skull base fractures: petrous and basilar fractures DAI
Any cervical spine fractures Complex facial fractures with midface instability
Cervical spine injury (cord, vertebral body, or ligaments) Combined significant head and chest trauma
Soft-tissue injury to anterior neck with swelling/ecchymosis/hematoma/or bruit Near-hanging
Significant neurologic deficit: lateralizing neurologic deficit, TIA, Horner syndrome Seat belt abrasions on neck
Evidence of brain infarct on CT Other unexplained neurologic deficits: vertigo, tinnitus, or GCS ≤6
Note:—DAI indicates diffuse axonal injury; GCS, Glasgow Coma Scale.
↵a First tier criteria: CTA screening on presentation.
↵b Second tier criteria: CTA screening within 24–48 hours of presentation.

First Tier^{^a}	Second Tier^{^b}
Skull base fractures: petrous and basilar fractures	DAI
Any cervical spine fractures	Complex facial fractures with midface instability
Cervical spine injury (cord, vertebral body, or ligaments)	Combined significant head and chest trauma
Soft-tissue injury to anterior neck with swelling/ecchymosis/hematoma/or bruit	Near-hanging
Significant neurologic deficit: lateralizing neurologic deficit, TIA, Horner syndrome	Seat belt abrasions on neck
Evidence of brain infarct on CT	Other unexplained neurologic deficits: vertigo, tinnitus, or GCS ≤6