ガイドライン意思決定
BCVIスクリーニング
鈍的頸部血管損傷の画像適応の整理。
計算例（数値代入）
以下の数値は本ツールの入力欄に定義された例示値であり、本ページの数式でサーバー側で実際に計算したものです。計算過程を素早く確認できます。代入方法の例示のみで、臨床上の助言ではなく、実在する症例でもありません。
| BCVI signs/symptoms (any): arterial bleeding from neck/nose/mouth, cervical bruit (<50 yr), expanding cervical hematoma, focal neurologic deficit (TIA/hemiparesis/Horner/vertebrobasilar), deficit incongruent with head CT, ischemic stroke on CT/MRI | None |
|---|---|
| 危険因子 (high-energy mechanism + any): Le Fort II/III, mandible fracture, skull-base/complex skull fracture, cervical spine fracture (esp. C1–3/transverse-foramen/subluxation), DAI or GCS <6, near-hanging with hypoxia, seatbelt/clothesline-type neck injury, scalp degloving, great-vessel chest injury | None |
→Screeningの推奨Screening not currently needed
- Decision：No corresponding signs/symptoms or risk factors; proceed with standard trauma evaluation and re-assess dynamically if needed
- Significance：BCVI (blunt carotid/vertebral injury) carries a ~【更新待ち】 stroke risk, highest within【更新待ち】 of injury; most are initially asymptomatic, so high-risk mechanisms are screened proactively
- 管理：Once confirmed, antithrombotic therapy (antiplatelet or anticoagulation) is usually given, weighing bleeding risk with trauma surgery (concomitant TBI/solid-organ/pelvic bleeding); follow by Biffl/Denver grade
| BCVI signs/symptoms (any): arterial bleeding from neck/nose/mouth, cervical bruit (<50 yr), expanding cervical hematoma, focal neurologic deficit (TIA/hemiparesis/Horner/vertebrobasilar), deficit incongruent with head CT, ischemic stroke on CT/MRI | ≥1 present |
|---|---|
| 危険因子 (high-energy mechanism + any): Le Fort II/III, mandible fracture, skull-base/complex skull fracture, cervical spine fracture (esp. C1–3/transverse-foramen/subluxation), DAI or GCS <6, near-hanging with hypoxia, seatbelt/clothesline-type neck injury, scalp degloving, great-vessel chest injury | ≥1 present |
→Screeningの推奨Neck CTA recommended
- Decision：Signs/symptoms or risk factors present → neck CT angiography (CTA) recommended to screen for BCVI; with signs/symptoms, obtain emergent imaging and treat bleeding/stroke early
- Significance：BCVI (blunt carotid/vertebral injury) carries a ~【更新待ち】 stroke risk, highest within【更新待ち】 of injury; most are initially asymptomatic, so high-risk mechanisms are screened proactively
- 管理：Once confirmed, antithrombotic therapy (antiplatelet or anticoagulation) is usually given, weighing bleeding risk with trauma surgery (concomitant TBI/solid-organ/pelvic bleeding); follow by Biffl/Denver grade
よくある質問
- BCVIスクリーニングとは何ですか？
- bcvi に基づく臨床評価・計算を支援します。結果は参考であり、診断の代替ではありません。
- BCVIスクリーニングはどのように計算しますか？核心の公式は？
- 配点・計算式は本ツールの入力項目および原典の定義に従います。
- BCVIスクリーニングはどのような場面で使いますか？
- 各領域のガイドライン、国内指針および施設プロトコルに従って使用してください。
- BCVIスクリーニングの臨床上の要点は？
- 結果は意思決定支援です。症状・検査・画像と総合判断してください。 単位・閾値は施設や測定法で異なる場合があります。 日本の関連学会指針がある場合はそちらを優先します。
- BCVIスクリーニングを使う際の制限と注意点は？
- 免許を有する医師および臨床研究者向け。結果は病歴・検査・施設プロトコルと合わせて解釈すること。診断や処方の代替ではなく、多職種意思決定や本地方針の代替にもなりません。
- BCVIスクリーニングは患者データをアップロードしますか？どこで計算しますか？
- 計算はブラウザ内でローカルに行われ、入力と結果はサーバーに送信されません。免許を有する医師向けであり、病歴・検査・施設プロトコルと合わせて解釈すること。診断や処方の代替ではありません。
- BCVIスクリーニングは実際にどう計算しますか？計算例を示せますか？
- 代入値: BCVI signs/symptoms (any): arterial bleeding from neck/nose/mouth, cervical bruit (<50 yr), expanding cervical hematoma, focal neurologic deficit (TIA/hemiparesis/Horner/vertebrobasilar), deficit incongruent with head CT, ischemic stroke on CT/MRI None、危険因子 (high-energy mechanism + any): Le Fort II/III, mandible fracture, skull-base/complex skull fracture, cervical spine fracture (esp. C1–3/transverse-foramen/subluxation), DAI or GCS <6, near-hanging with hypoxia, seatbelt/clothesline-type neck injury, scalp degloving, great-vessel chest injury None → 結果: Screeningの推奨 Screening not currently needed（Decision: No corresponding signs/symptoms or risk factors; proceed with standard trauma evaluation and re-assess dynamically if needed、Significance: BCVI (blunt carotid/vertebral injury) carries a ~【更新待ち】 stroke risk, highest within【更新待ち】 of injury; most are initially asymptomatic, so high-risk mechanisms are screened proactively、管理: Once confirmed, antithrombotic therapy (antiplatelet or anticoagulation) is usually given, weighing bleeding risk with trauma surgery (concomitant TBI/solid-organ/pelvic bleeding); follow by Biffl/Denver grade） 代入値: BCVI signs/symptoms (any): arterial bleeding from neck/nose/mouth, cervical bruit (<50 yr), expanding cervical hematoma, focal neurologic deficit (TIA/hemiparesis/Horner/vertebrobasilar), deficit incongruent with head CT, ischemic stroke on CT/MRI ≥1 present、危険因子 (high-energy mechanism + any): Le Fort II/III, mandible fracture, skull-base/complex skull fracture, cervical spine fracture (esp. C1–3/transverse-foramen/subluxation), DAI or GCS <6, near-hanging with hypoxia, seatbelt/clothesline-type neck injury, scalp degloving, great-vessel chest injury ≥1 present → 結果: Screeningの推奨 Neck CTA recommended（Decision: Signs/symptoms or risk factors present → neck CT angiography (CTA) recommended to screen for BCVI; with signs/symptoms, obtain emergent imaging and treat bleeding/stroke early、Significance: BCVI (blunt carotid/vertebral injury) carries a ~【更新待ち】 stroke risk, highest within【更新待ち】 of injury; most are initially asymptomatic, so high-risk mechanisms are screened proactively、管理: Once confirmed, antithrombotic therapy (antiplatelet or anticoagulation) is usually given, weighing bleeding risk with trauma surgery (concomitant TBI/solid-organ/pelvic bleeding); follow by Biffl/Denver grade）
医療従事者向けの意思決定支援です。臨床判断・最新ガイドライン・施設プロトコルの代替にはなりません。