Background: This study evaluates the utility of CT angiography (CTA) and the Expanded Denver Criteria (EDC) in detecting blunt cerebrovascular injuries (BCVI) in blunt cervical trauma, assaults, and strangulation. Methods: A retrospective review of 748 patients undergoing CTA for blunt cervical trauma, assaults, and strangulation (2013–2023) was conducted. After exclusions, 344 CTA reports were analyzed. Inclusion criteria: patients ≥18 years with complete medical records who underwent CTA for trauma evaluation. Exclusions: penetrating injuries, preexisting cerebrovascular abnormalities, incomplete records, or CTA not performed. Results: BCVI was identified in 38/344 cases (11%), with 55% classified as Grade I (Biffl). Posterior circulation (71%) and internal carotid arteries (36.8%) were most affected. Eight BCVI cases (21%) did not meet EDC; MVCs accounted for seven. MVCs (68%) and falls (29%) were the leading causes, while no BCVIs were observed in assaults or strangulations. Conclusions: MVCs and high-impact falls pose the highest BCVI risk, warranting CTA beyond EDC indications. In contrast, CTA may be less necessary for assaults and strangulations. Further studies across trauma centers are needed to confirm these findings.