Biffl scale for blunt cerebrovascular injury

Changed by Craig Hacking, 11 Dec 2015

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Title was changed:

Biffl ~~criteria~~scale for blunt cerebrovascular injury

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The Biffl ~~Criteria~~scale ~~illustrates~~or grade illustrates the spectrum of blunt cerebrovascular injury (BCVI) seen on angiography (both CTA and DSA). ~~This~~Some authors refer to the grading ~~system has prognostic~~scale as the Denver scale, which is not to be confused with the Denver criteria, a set of clinical and ~~therapeutic implications~~risk factors for BCVI.

Classification

grade I: mild intimal injury or irregular intima
grade II: dissection with raised intimal flap / intramural haematoma with luminal narrowing >25% / intraluminal thrombosis
grade III: pseudoaneurysm
grade IV: vessel occlusion/thrombosis
grade V: vessel transection.

Treatment and prognosis

~~Stroke~~This grading system has prognostic and therapeutic implications. Stroke risk increased with injury grade~~. The~~, the lower the grade the better the prognosis ¹.

grade I: heals regardless of therapy
grade II: 70% of dissections or haematomes with luminal stenosis progressed while on heparin therapy
grade III: only % of pseduoaneurysms healed with heparing and ~90% resolved after stenting
grade IV: occluded carotid arteries did not recanalise in the early post-injury period
grade V: transections are lethal and refractory to therapy

-<p>The <strong>Biffl Criteria</strong> illustrates the spectrum of <a href="/articles/blunt-cerebrovascular-injury">blunt cerebrovascular injury</a> (BCVI) seen on angiography (both CTA and DSA). This grading system has prognostic and therapeutic implications.</p><h4>Classification</h4><ul>
+<p>The <strong>Biffl scale </strong>or<strong> grade</strong> illustrates the spectrum of <a href="/articles/blunt-cerebrovascular-injury">blunt cerebrovascular injury</a> (BCVI) seen on angiography (both CTA and DSA). Some authors refer to the grading scale as the <strong>Denver scale</strong>, which is not to be confused with the <a href="/articles/denver-criteria-for-blunt-cerebrovascular-injury-1">Denver criteria</a>, a set of clinical and risk factors for BCVI. </p><h4>Classification</h4><ul>
~~-<strong>grade III</strong>: <a title="Pseudoaneurysm" href="/articles/false-aneurysm">pseudoaneurysm</a>~~
+<strong>grade III</strong>: <a href="/articles/false-aneurysm">pseudoaneurysm</a>
~~-</ul><h4>Treatment and prognosis</h4><p>Stroke risk increased with injury grade. The lower the grade the better the prognosis 1</p><ul>~~
+</ul><h4>Treatment and prognosis</h4><p>This grading system has prognostic and therapeutic implications. Stroke risk increased with injury grade, the lower the grade the better the prognosis <sup>1</sup>.</p><ul>

References changed:

2. Cothren CC, Moore EE. Blunt cerebrovascular injuries. Clinics (Sao Paulo). 2006;60 (6): 489-96. <a href="http://www.ncbi.nlm.nih.gov/pubmed/16358140">Pubmed citation</a><span class="auto"></span>