Multicenter Validation of the McGovern Pediatric Blunt Cerebrovascular Injury Screening Score.

Blunt cerebrovascular injury (BCVI) is defined as blunt trauma to the head and neck leading to damage to the vertebral and/or carotid arteries; which children are considered "high-risk" and in need of angiographic/vessel imaging varies. We previously proposed a screening tool, the McGovern Score, to identify pediatric trauma patients at high risk for BCVI, and we aim to validate the McGovern score by pooling data from multiple pediatric trauma centers. This is a multicenter, hospital-based, cohort study from all prospectively registered pediatric (<16 years) trauma patients who presented to the emergency department between 2003 and 2017 at 6 level 1 pediatric trauma centers. The registry was retrospectively queried for patients who received a CTA as a screening method for BCVI. Age, length of follow-up, mechanism of injury, arrival Glasgow Coma Scale (GCS), and focal neurological deficit were recorded. Radiological variables queried were the presence of a carotid canal fracture, petrous temporal bone fracture, and CT presence of infarction. Patients with BCVI were queried for mode of treatment, type of intracranial injury, artery damaged, and BCVI injury grade. The McGovern score was calculated for all patients who underwent CTA across all data groups. A total of 1012 patients underwent CTA; 72 of these patients were found to have BCVI, 51 of which were in the validation cohort. Across all data groups, the McGovern score has a >80% sensitivity and >98% NPV. The McGovern Score for Pediatric BCVI is an effective, generalizable screening tool.