Modified Memphis criteria for blunt cerebrovascular injury

The modified Memphis criteria are a set of screening criteria for blunt cerebrovascular injury (BCVI) in trauma. The presence of one or more of these criteria makes necessary a complementary CTA or DSA study to exclude a BCVI.

The screening protocol criteria for BCVI are:

• base of skull fracture with involvement of the carotid canal
• base of skull fracture with involvement of petrous temporal bone
• cervical spine fracture
• neurological exam findings not explained by neuroimaging
• Horner syndrome
• Le Fort II or III fracture pattern
• neck soft tissue injury (e.g. seatbelt sign, hanging, hematoma)

Ciapetti et al. showed that a modification of the original Memphis criteria could increase the sensitivity of BCVI . If a trauma patient meets one or many of these criteria, the diagnosis of BCVI should be excluded with CTA or DSA. DSA is far more sensitive than 32-MDCT but less available. However, a study retrospectively applying the criteria has recently concluded that CTA should be performed on all multi-trauma patients for 37.5% of injuries would have been missed .

See also

• Denver criteria of BCVI