Cervical, Whiplash - Medical Research Abstracts

14. AUTHOR	Pressman-B-D, Shellock-F-G, Schames-J, Schames-M.
INSTITUTION	Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, CA.
TITLE	MR imaging of temporomandibular joint abnormalities associated with cervical hyperextension/hyperflexion (whiplash) injuries.
SOURCE	J-Magn-Reson-Imaging 1992 Sep-Oct, VOL: 2 (5), P: 569-74, ISSN: 1053-1807.
ABSTRACT	Patients often have temporomandibular joint (TMJ) dysfunction-related symptoms after cervical hyperextension/hyperflexion injuries ("whiplash") caused by rear-end motor-vehicle collisions. To determine abnormalities of the TMJ associated with these injuries, 33 consecutive symptomatic patients (66 joints) with no direct trauma to the jaw, mouth, head, or face due to the accident and no prior history of TMJ dysfunction underwent magnetic resonance (MR) imaging, and the images were retrospectively analyzed. Overall, 29 (88%) patients had some type of TMJ abnormality related to whiplash injury. Displacement of the disk was seen in 37 (56%) of the TMJs as follows: 21 (32%) had anterior displacement with reduction, nine (14%) had anterior displacement without reduction, six (9%) had lateral or medial displacement, and one (2%) had posterior displacement. On T2- weighted images, 43 (65%) TMJs had abnormal joint fluid or edema, predominantly affecting the joint capsule and/or lateral pterygoid muscles. The finding that many of the patients had joint fluid and/or soft-tissue edema indicates that T2-weighted images are especially useful for assessment of patients with a history of whiplash injury. Author.

15. AUTHOR	Ettlin-T-M, Kischka-U, Reichmann-S, Radii-E-W, Heim-S, Wengen-D, Benson-D-F.
INSTITUTION	University Clinics, Basel, Switzerland.
TITLE	Cerebral symptoms after whiplash injury of the neck: a prospective clinical and neuropsychological study of whiplash injury (see comments).
SOURCE	J-Neurol-Neurosurg-Psychiatry 1992 Oct, VOL: 55 (10), P: 943-8, ISSN: 0022-3050.
CM	Comment in: J-Neurol-Neurosurg-Psychiatry 1993 Dec; 56(12):1328-9.
ABSTRACT	Twenty one unselected patients with an acute whiplash injury of the neck had neurological and neuropsychological assessment, cervical x rays, EEG, BAEP, MRI, and an otoneurological examination within two weeks of the injury. Subjectively, 13 patients reported concentration deficits, 18 reported sleep disturbances, 9 had symptoms of depression, and 7 female patients told of menstrual irregularities. Neuropsychological examination revealed significantly lower performance in tests related to attention and concentration compared to sex, age and educational matched control subjects. Otoneurological examination showed abnormalities in 9 of 17 whiplash subjects. EEG showed questionable changes in 8 of 18 recordings. MRI and BAEP were normal in all patients. Repeat neuropsychological testing in 15 patients at three months showed that attention deficits had improved but were still shown in 12 of 14 and the concentration deficits in 8 of 13 patients. At one year all patients had returned to work, 16 to full and 5 to part time employment. In 4, cognitive dysfunction remained the only significant problem. These findings are discussed as being compatible with possible damage to basal frontal and upper brain stem structures after whiplash injury of the neck. Author.

16. AUTHOR	Oosterveld-W-J, Kortschot-H-W, Kingma-G-G, de-Jong-H-A, Saatci-M-R.
INSTITUTION	Academisch Medisch Centrum, University of Amsterdam, The Netherlands.
TITLE	Electronystagmographic findings following cervical whiplash injuries.
SOURCE	Acta-Otolaryngol (Stockh) 1991, VOL: 111 (2), P: 201-5, ISSN: 0001-6489.
ABSTRACT	A group of 262 patients suffering from the after-effects of an acceleration trauma of the neck were subjected to an extensive vestibular examination. 85% of the patients complained of some type of vertigo. The visual suppression test conducted during rotation showed pathology in 37% of the cases. Visual pursuit movements were affected in 43% of the cases. In a group of 41 patients the results obtained respectively 1 and 2 years after the accident were compared. There was no significant improvement of the findings. No oculomotor system pathology was found in 99 cases (38%), and no electronystagmographic pathology at all in 55 cases (21%). The study emphasized the fact that nystagmographic examinations are able to detect central vestibular dysfunction and is therefore a suitable method to prove pathology. Author.

17. AUTHOR	Weinberg-S, Lapointe-H.
INSTITUTION	Faculty of Dentistry, University of Toronto, Canada.
TITLE	Cervical extension-flexion injury (whiplash) and internal derangement of the temporomandibular joint.
SOURCE	J-Oral-Maxillofac-Surg 1987 Aug, VOL: 45 (8), P: 653-6, ISSN: 0278-2391.
ABSTRACT	Twenty-eight patients with post-whiplash temporomandibular joint (TMJ) symptoms were assessed. Internal derangements were seen arthrographically in 22/25 patients. These observations were confirmed in the 10 patients who elected to have surgery. Author.

18. AUTHOR	Radanov-B-P, Dvorak-J, Valach-L.
INSTITUTION	Psychiatrische Universitatspoliklinik Bern.
TITLE	(Psychological changes following whiplash injury of the cervical vertebrae). TT Psychische Veranderungen nach Schleuderverletzungen der Halswirbelsaule.
SOURCE	Schweiz-Med-Wochenschr 1989 Apr 29, VOL: 119 (17), P: 536-43, ISSN: 0036-7672.
ABSTRACT	To evaluate the frequently attributed psychogenic origin of symptoms following "whiplash" injury, 66 patients who had suffered such an injury underwent clinical and psychometric examination. Data were collected on subjective symptoms and their possible psychogenic origin and psychopathology. Personality profile, subjective well- being and cognitive impairment were evaluated. The amount of long- lasting psychopathological alterations was comparatively small. The results do not support the notion of a psychogenic origin for symptoms after "whiplash" injury; personality traits and psychopathology do not explain the nature of the complaints. Author.

19. AUTHOR	Maimaris-C, Barnes-M-R, Allen-M-J.
INSTITUTION	Accident and Emergency Department, Leicester Royal Infirmary.
TITLE	'Whiplash injuries' of the neck: a retrospective study.
SOURCE	Injury 1988 Nov, VOL: 19 (6), P: 393-6, ISSN: 0020-1383.
ABSTRACT	This is a retrospective study of 102 patients with whiplash injuries of the neck followed up at approximately 2 years. The results show that 67 patients were asymptomatic by this time and the remaining 35 patients still exhibited symptoms. Prognostic indicators were found to be age, occipital headaches, referred symptoms, interscapular pain, abnormal neurological signs, positive radiological findings and osteoarthritic changes of the cervical spine. Symptoms that persisted for more than 2 months indicated prolonged disability. Author.

20. AUTHOR	Heckl-R-W, Baum-R.
INSTITUTION	Abteilung Akute und Allgemeine Neurologie, Rehabilitationskrankenhauses, Karlsbad.
TITLE	(Episodes of amnesia following whiplash injury to the cervical spine). TT Amnestische Episode nach Schleudertrauma der Halswirbelsaule.
SOURCE	Aktuelle-Traumatol 1984 Feb, VOL: 14 (1), P: 33-6, ISSN: 0044-6173.
ABSTRACT	A so-called conscious post-traumatic twilight state ("besonnener Dammerzustand") after a whiplash injury is described here, showing up its similarities with a classic post-traumatic conscious twilight state on the one hand and a classic transient global amnesia on the other hand. The term "conscious twilight state" is analysed and found inappropriate for the state it is meant to describe, and hence the term "post-traumatic transient global amnesia" is proposed instead. A post-traumatic transient global amnesia after whiplash injury is considered to be caused by a concussion. Author.

21. AUTHOR	Saternus-K-S.
INSTITUTION	Institut fur Rechtsmedizin der Universitat.
TITLE	(Writing of expertises on whiplash injuries of the cervical spine (author's transl)). TT Die Begutachtung des Schleudertraumas der Halswirbelsaule.
SOURCE	Aktuelle-Traumatol 1982 Jan, VOL: 12 (1), P: 4-11, ISSN: 0044-6173.
ABSTRACT	Reflections on the definition of the term "whiplash injury" are followed by comments on the mechanism of accidents. The author emphasizes the importance of the biphasic course of the trauma, involving a mass contraction, triggered by reflex action, of the initially suddenly overstretched muscle groups with their synergist. Reference is made to the ideas developed by Kummer, who considers the neck as an arcuate tendon construction with tractional tension on the dorsal as well as on the ventral side. In the analysis of the injury pattern of the cervical spine, the special forms of intervertebral disc injury are dealt with, the relationship to degenerative lesions prior to the accident and to secondary lesions (spondylosis deformans and osteochondrosis) are discussed in detail, and the consequences for writing medical expertises are mentioned. Author.

22. AUTHOR	Buhring-M.
INSTITUTION	Klinikum der Johann Wolfgang Goethe-Universitat Zentrum der Inneren Medizin.
TITLE	(Reflex dystrophy following so-called whiplash injury of the cervical spine). TT Reflexdystrophie nach sogenanntem Schleudertrauma der HWS.
SOURCE	Z-Orthop 1984 May-Jun, VOL: 122 (3), P: 281-6, ISSN: 0044-3220.
ABSTRACT	In bad cases of whiplash injury of the cervical spine the post- accidental course is complicated by pain, vegetative dysfunctional syndromes and by psychic and psychiatric disorders over many years. There is no satisfactory concept to understand the pathophysiology of these processes. The paper deals with the possibility of a reflex dystrophy. Sympathetic reflex dystrophy syndromes are seen principally in patients with joint, tendon or vascular lesions. In case of whiplash injury, it would concern the cervical spine itself as well as visceral organs including the central nervous system. For the CNS the lymphostatic encephalopathy is a well defined entity. Above all, a reflex dystrophy develops on the basis of a special personality structure. In case of psychic and psychiatric complaints after whiplash injury patients with a so called Sudeck-personality should not be suspected to aggravate; in contrast, especially in these patients complications by reflex dystrophy are credible. Consequences for the assessment and for rehabilitation are discussed. Author.

23. AUTHOR	Suter-J, Mumenthaler-M.
INSTITUTION	Neurologische Klinik Der Universitat Bern, Schweiz.
TITLE	(Criteria for determining whether to offer compensation in cases of whiplash injury to the spine (neck area). A study of cases in which compensation or cash settlement has been granted (author's transl)). TT Gutachterliche Aspekte bei Schleuderverletzungen der Halswirbelsaule. Eine Studie von Fallen, die eine Rente oder Kapitalabfindung erhielten.
SOURCE	Arch-Orthop-Unfallchir 1977 Dec 27, VOL: 90 (3), P: 325-42, ISSN: 0003-9330.
ABSTRACT	We compared two groups of patients with whiplash injury. The first group of 17 patients received a life annuity or a cash settlement, whereas the second group, comprised of 84 people, received no compensation at all. This comparison revealed some considerable differences. However, with regard to statistically significant factors, the 2 groups differ only in neurological symptoms, giddiness, and degenerative changes revealed by X-ray. In the first group, 11 patients who received compensation showed two of the statistically significant factors; 5 patients showed one factor; and 1 showed none. The criteria which govern the granting of compensation are being discussed in detail on the basis of our own cases and the literature. It is an exception when permanent damage due to whiplash is accepted. In individual cases, however, continuous complaints and objective findings years after the trauma are justification for a moderate compensation. Author.

24. AUTHOR	Schmitt-H-P, Gladisch-R.
INSTITUTION	Institut Fur Neuropathologie Heidelberg 1.
TITLE	(Multiple fractures of the atlas with delayed fatal thrombosis of vertebral artery following "whiplash" injury of the neck (author's transl)). TT Multiple Frakturen des Atlas mit zweizeitiger todlicher Vertebralisthrombose nach Schleudertrauma der Halswirbelsaule.
SOURCE	Arch-Orthop-Unfallchir 1977 Feb 28, VOL: 87 (2), P: 235-44, ISSN: 0003-9330.
ABSTRACT	Report of the case of a 62 year old male, who died in a car crash on his way home from duty, when he had a frontal collison with annother car at a speed of about 70 km per hour. After the collision, the car had completely turned over to its wheels. As the man had put on the seat belts, he had not been cast against the front window so that there were no head injuries. Following an unconsciousness of about ten minutes the patient recovered quickly and was already fully oriented when arrived at hospital. No neurological symptoms could be substantiated. He only suffered from pain of the neck and had a marked swelling of the left side of the neck. A burstin fracture of the atlas vertebra (Jefferson-fracture) was overlooked in routine X- rays of the craniovertebral region. Eight days after the accident, the hitherto "well improving" patient died suddenly and unexpectedly. The autopsy revealed an obstructing thrombosis of the left vertebral artery, less than 24 hours old. The wall of the artery showed numerous dissecting ruptures with intramural bleedings. Author.

25. AUTHOR	Fischer-D, Palleske-H.
INSTITUTION	Neurochirurgischen Klinik Der Universitat Des Saarlandes Homburg /Saar.
TITLE	(EEG after so-called whiplash injury of cervical vertebral column (cervicocephalic acceleration trauma)). TT Das EEG nach der sogenannten Schleuderverletzung der Halswirbelsaule (zerviko-zephales Beschleunigungstrauma).
SOURCE	Zentralbl-Neurochir 1976, VOL: 37 (1), P: 25-35, ISSN: 0044-4251.
ABSTRACT	The results of electroencephalographic examinations made on four groups of patients are compared. These groups include 80 patients with cervicocephalic syndromes due to flinging injuries to the cervical vertebral column, 80 patients with postconcussive syndromes, and 39 patients whose anamneses suggested conditions resulting from the two kinds of injury referred to above. A fourth group of 40 patients with nontraumatic spondylosis deformans cervicalis is compared with the first three groups of patients. The rate (49 percent, 52 percent, and 54 percent), kind, and distribution of electroencephalographically determined abnormalities are in agreement with those obtained for the first three groups. For patients with nontraumatic cervicocephalic syndromes the rate of general alterations determined from records obtained by means of the electroencephalograph is equal to the occurrence of constitutional EEG variants, the rate being of the order of 10 percent. EEG alterations observed in the case of flinging traumata are considered to de due to acceleration injuries to the cranial contents. Author.

26. AUTHOR	Wiesner-H, Mumenthaler-M.
TITLE	(Whiplash injuries of the cervical spine. A catamnestic study). TT Schleuderverletzungen der Halswirbelsaule. Eine katamnestische Studie.
SOURCE	Arch-Orthop-Unfallchir 1975, VOL: 81 (1), P: 13-36, ISSN: 0003-9330.
ABSTRACT	Whiplash injuries of the cervical spine are due to the rapid sequence of movements in opposite direction. They are mainly following rear- end collisions where the trunk is pushed rapidly forward. Very important forces act therefore on the different segments of the cervical spine and lead to lesions of the perispinal soft tissues, of the ligaments, of the disks and the bony structures. In 24 tables, the signs and symptoms in 104 personal cases observed for a period which lasted more than 4 years are described. Amongst the clinical signs there are cervical strain, cervico brachial pain, headaches, radicular signs as well as symptoms of concussion and cercial medullar lesion. Radiological findings are discrete; functional X- rays sometimes show local diminution of motility in a single segment. The treatments, amongst these immobilisation and local heat, are discussed. The unusually long duration of local disturbance is stressed. Signs of neurasthenia are part of the typical findings and do not at all mean a secondary neurotic development. Author.

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