Figure 2 CTA brain coronal selleck kinase inhibitor image demonstrating diminutive right posterior communicating artery. A list of Denver BCVI screening criteria is listed below: The Denver criteria for screening for BCVI in context of AP26113 supplier trauma includes any cervical fracture, unexplained neurological deficit, basal cranial fracture into the carotid canal, Le Fort 2 or 3 fracture, cervical hematoma, cervical bruit, ischemic stroke, or head injury with GCS <6. Below is the University of Florida Severe Brain Injury Protocol which was followed during the treatment of this patient (Figure 3). Figure 3 University of Florida severe brain injury algorithm. Discussion Thus far, there exist a total of 3 case reports of cerebrovascular accident

associated with blunt trauma in Rugby. The first is a 15 year old playing hooker (middle front row in the scrum) with a trauma associated CVA that presented

with primarily sensory symptoms that included neck pain and paresthesia of right arm and leg [1]. He was removed from the game and did not return to play. He developed additional symptoms the following day including dizziness and blurred vision with ongoing right upper extremity paraesthesia. MR imaging revealed an BMN 673 chemical structure infarct in the anterior limb of the internal capsule and the head of the caudate nucleus. A diagnosis of carotid dissection was made as a source without angiography based on history and distribution of infarct the patient. This was treated conservatively without anticoagulation or antiplatelet therapy with near 4-Aminobutyrate aminotransferase full resolution of his symptoms with residual numbness of the hand at follow up 4 weeks later. The second case is a 31 year old who sustained a ‘fierce hand off’ to the right neck while playing but continued to play without neurological signs or symptoms [2].

He then presented 2 weeks later to the ED with right neck swelling and pain with shortness of breath and a diagnosis of ruptured pseudoaneurysm of the common carotid was made with subsequent open surgical intervention. He had a presented to a general practitioner one week post injury and received antibiotic therapy for a swollen gland in the neck. Interestingly he had no neurological symptoms or signs as part of his presentations. The third is a 19 year old rugby player who sustained a posterior sternoclavicular dislocation that required he retire from the game [3]. He had no neurological signs or symptoms, only pain associated with the injury. He then presented 3 weeks post injury with dizziness and collapse on the rugby pitch, which was diagnosed as secondary to two vascular injuries one of the right proximal subclavian artery and the other of the innominate artery. He received surgical intervention including a median sternotomy, and at 1 year had residual neurological deficit of left UE and LE. Additional case reports of BCVI in include a series of 5 cases that include one sport-related BCVI.