Blunt carotid injury (BCI) and blunt vertebral injury, collectively known as BCVI, have historically been considered rare, but potentially devastating, events. Early multicenter reviews collectively reported BCI-related mortality rates of 23%, with 48% of survivors suffering permanent severe neurologic sequelae.^1–4 In these reviews, the collective incidence of BCI was noted to be 0.1% among blunt trauma victims admitted to trauma centers. In the latter part of the 1990s, with awareness heightened by the landmark series from Memphis,⁵ the reported incidence of BCI increased to 0.24%–0.4%.^5–7 The Denver group confirmed that many injuries were clinically occult⁸ and instituted liberal screening of asymptomatic patients in the mid- 1990s.⁹ Screening for BCVI has now become widespread, and several centers have reported an incidence of BCVI exceeding 1% of blunt trauma admissions.^10–15