Cervicogenic Headache (Ceh) After Whiplash Injury

Drottning, Monica; Staff, PH; Sjaastad, Ottar

doi:10.1046/j.1468-2982.2002.00315.x

Cited by 77 publications

(49 citation statements)

References 9 publications

(23 reference statements)

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“…Most recently, Carroll et al performed a meta-analysis of the literature pertaining to whiplash injury. When considering all whiplash patients, 44% to 66% of patients had symptoms at one year, but only 12% reported daily neck pain and only 9% reported significant health impairment as a result of the whiplash injury [26][27][28]. Others have shown that 90% of patients presenting with neck pain and neurological signs (WAD III) have continued symptoms at one-year following the injury [29].…”

Section: Discussionmentioning

confidence: 99%

Clinical and Finite Element Analysis of Acute Whiplash

Tannoury¹,

Rihn²,

Wilson³

et al. 2011

TOSPINEJ

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Study Design:A prospective 1-year follow-up study of whiplash patients presenting with neurological signs/or symptoms (WADIII), and whiplash patients with neck pain but no neurologic findings (WADI/II). Objective:We hypothesize that WADI/II and WADIII are distinct entities, with regards to clinical presentation, pathoanatomy, and prognosis.Summary of Background Data: symptoms associated with whiplash injury range from mild neck pain (WADI/II), to injuries associated with neurologic sequellae (WADIII). To date, literature considers whiplash associated disorders (WAD) a single clinical and pathologic entity, with different grades of severity (WADI-IV).Methods: Thirty one subjects were divided into a WADIII study group and a WADI/II comparison group. All subjects underwent H&P, radiographic evaluations, and clinical outcome measures (collected at 3, 6, and 12 months). Statistical analysis was performed (Student T-test, Wilcoxon Signed-Rank test) with significance set at p=0.05. A finite element analysis (FEA) technology (SCOSIA©) was used to predict stresses within the neuraxis.Results: At day 0: Better neurologic assessments, functional performances, and higher quality-of-life measurements were noted in WADI/II compared to WADIII. VAS scores were comparable.At 12 months: Both groups reported improvements in neurologic status and disability symptoms. However functional recovery and quality-of-life measures significantly improved in WADIII, and conversely deteriorated in WADI/II along with notable worsening of pain symptoms. Litigation claims were comparable. FEA predicted higher stress within the neuraxis of WADIII, notably in subjects with preexisting stenosis and odontoid retroflexion. Conclusion:WADI/II and WADIII are distinct entities. Musculoskeletal injury precipitates WADI/II pain symptoms while neuronal stretching leads to WADIII neurologic injuries, which are mostly recoverable.

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Section: Discussionmentioning

confidence: 99%

Clinical and Finite Element Analysis of Acute Whiplash

Tannoury¹,

Rihn²,

Wilson³

et al. 2011

TOSPINEJ

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“…As CEH diagnosis consists of two components (case history and clinical examination), normalcy could be defined as indicating return to status quo of both, not only of the subjective symptoms. There is some recent evidence that clinical "scars" can persist longer than the symptoms [25].…”

Section: Discussionmentioning

confidence: 99%

“…Anyhow, the latter study provides relatively strong evidence against degenerative changes as a significant aetiological factor, at least in some CEH cases. The Oslo whiplash study [25] furnishes evidence for de novo headache after whiplash injury, i.e., in 3.4% of the cases, at 1 year. An intricate situation is, however, apparent.…”

Section: Cervicogenic Headache and Neck Traumamentioning

confidence: 99%

“…Degenerative processes can hardly explain a mean onset at 23 years (range: [19][20][21][22][23][24][25][26][27][28][29], observed in a recent investigation [31], where 11 of 14 patients (79%) had sustained a -mostly indirect -neck trauma, prior to the development of CEH. That particular series was highly selected: females with pregnancies after onset of CEH.…”

Section: Cervicogenic Headache and Neck Traumamentioning

confidence: 99%

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Whiplash in individuals with known pre–accident, clinical neck status

Sjaastad

Fredriksen

Batnes³

et al. 2006

J Headache Pain

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In whiplash studies, there may be interpretation difficulties: are post–whiplash findings, when present, a consequence of the whiplash trauma, or did they exist prior to trauma? In the Vågå headache epidemiology study (1995–1997), there was a headache history and detailed physical/neurological findings from the face/head/neck in 1838 18–65–year-old parishioners. In September 2001, four years after the Vågå study, a search through the Health Centre files divulged six cases with whiplash trauma in the intervening period. These parishioners could thus be their own controls. Two females did not develop new complaints. In the four parishioners with apparently new, subjective complaints, i. e., headache, neck pain, and a feeling of stiffness in the neck, there were corresponding findings as regards various parameters: shoulder area skin–roll test , changes in two, possible changes in two; range of motion, neck , changes in two, borderline changes in one; “ features indicative of cervical abnormality ” (“CF”), changes in all four; the mean, post–whiplash stage value was: 3.6+, against 1.6+ prior to accident (Vågå: only 0.93%, “CF” exceeding 3+). In the two without new complaints, the mean “CF” value was 1.0+. The number of cases is small, but the similarity of the symptoms—and signs—following whiplash injury may suggest an element of organic origin in the whiplash syndrome.

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“…Conclusions: In light of the inherent limitations of our retrospective study, AA PRF treatment can only be tentatively viewed as a promising treatment modality for whiplash patients with CEH and is subject to validation in future studies. (WAD) are very costly to society, and patients have rated headaches as the most burdensome WAD (2). The prevalence of CEH had been estimated as high as 4.1% in the general population and as high as 17.5% among patients with severe headaches.…”

Section: Introductionmentioning

confidence: 99%