Whiplash, Cervical - Medical Research Abstracts

1. AUTHOR	Garcia-R-Jr, Arrington-J-A.
INSTITUTION	Department of Radiology at the University of South Florida College of Medicine, USA.
TITLE	The relationship between cervical whiplash and temporomandibular joint injuries: an MRI study.
SOURCE	Cranio 1996 Jul, VOL: 14 (3), P: 233-9, ISSN: 0886-9634.
ABSTRACT	Temporomandibular joint (TMJ) symptoms are a common finding in motor vehicle accident (MVA) patients with hyperextension/hyperflexion injuries of the cervical spine (cervical whiplash). The relationship between cervical whiplash and TMJ injuries was documented with magnetic resonance imaging (MRI) in 87 consecutive MVA cervical whiplash patients who presented with TMJ symptoms and had sustained no direct trauma to the face, head or mandible and had no TMJ complaints prior to the MVA. One hundred sixty-four TMJ patients were evaluated for internal derangement, effusion and inflammation, utilizing T1 and T2 weighted images. A high percentage of the TMJ patients demonstrated abnormal findings: disk displacement with reduction (DDR), 118/164 (72%); disk displacement without reduction (DDNR), 25/164 (15%); effusion, 113/164 (69%); inflammation or edema, 84/164 (51%); total TMJ abnormalities, 156/164 (95%). The high percentage of TMJ abnormalities in this study significantly illustrates the proximate relationship between cervical whiplash and TMJ injuries. Author.

2. AUTHOR	Otte-A, Ettlin-T-M, Fierz-L, Kischka-U, Muerner-J, Hogerle-S, Brautigam-P, Mueller-Brand-J.
INSTITUTION	Institut fur Nuklearmedizin, Universitatskliniken, Kantonsspital Basel.
TITLE	(Cerebral findings following cervical spine distortion caused by acceleration mechanism (whiplash injury). Assessment of current diagnostic methods in nuclear medicine). TT Zerebrale Befunde nach Halswirbelsaulendistorsion durch Beschleunigungsmechanismus (HWS-Schleudertrauma). Standortbestimmung zu neuen diagnostischen Methoden der Nuklearmedizin.
SOURCE	Schweiz-Rundsch-Med-Prax 1996 Sep 3, VOL: 85 (36), P: 1087-90, ISSN: 0369-8394.
ABSTRACT	In any grade of distortion of the cervical spine as a result of acceleration forces in addition to cervical symptoms cerebral symptoms like headache, vertigo, auditory disturbances, tinnitus, disturbances in concentration and memory, difficulties in swallowing, impaired vision and temporo-mandibular dysfunctions may appear. These symptoms can persist and become invalidating. Cerebral single-photon emission tomography (SPECT) and positron emission tomography (PET) enable new diagnostic horizons for neurotraumatology. In this article we summarize the actual findings of these nuclear medical methods in neuropsychologically deficient patients with distortion of the cervical spine as a result of acceleration forces. Especially the latest results of the group of Basle (University Hospital Basle, Clinic of Rehabilitation Rheinfelden, Switzerland) are illustrated. This group found parieto-occipital hypoperfusion by relative quantitation using SPECT and bicisate (Neurolite, ECD). A first pilot study using PET and F-18-fluoro-deoxyglucose (FDG) could verify the above observation. The group's working hypothesis is that parieto- occipital hypoperfusion may be caused by activation of nociceptive afferences from the upper cervical spine. A critical approach to interpreting new functional methods and, on the other hand, openness in new scientific findings may contribute to answering the lasting controversial medico-legal discussion with more objectivity. Author.

3. AUTHOR	Woltring-H-J, Long-K, Osterbauer-P-J, Fuhr-A-W.
INSTITUTION	Whiplash Analysis Incorporation, Phoenix, AZ 85018.
TITLE	Instantaneous helical axis estimation from 3-D video data in neck kinematics for whiplash diagnostics.
SOURCE	J-Biomech 1994 Dec, VOL: 27 (12), P: 1415-32, ISSN: 0021-9290.
ABSTRACT	To date, the diagnosis of whiplash injuries has been very difficult and largely based on subjective, clinical assessment. The work by Winters and Peles Multiple Muscle Systems--Biomechanics and Movement Organization. Springer, New York (1990) suggests that the use of finite helical axes (FHAs) in the neck may provide an objective assessment tool for neck mobility. Thus, the position of the FHA describing head-trunk motion may allow discrimination between normal and pathological cases such as decreased mobility in particular cervical joints. For noisy, unsmoothed data, the FHAs must be taken over rather large angular intervals if the FHAs are to be reconstructed with sufficient accuracy; in the Winters and Peles study, these intervals were approximately 10 degrees. in order to study the movements' microstructure, the present investigation uses instantaneous helical axes (IHAs) estimated from low-pass smoothed video data. Here, the small-step noise sensitivity of the FHA no longer applies, and proper low-pass filtering allows estimation of the IHA even for small rotation velocity omega of the moving neck. For marker clusters mounted on the head and trunk, technical system validation showed that the IHAs direction dispersions were on the order of one degree, while their position dispersions were on the order of 1 mm, for low-pass cut-off frequencies of a few Hz (the dispersions were calculated from omega-weighted errors, in order to account for the adverse effects of vanishing omega). Various simple, planar models relating the instantaneous, 2-D centre of rotation with the geometry and kinematics of a multi-joint neck model are derived, in order to gauge the utility of the FHA and IHA approaches. Some preliminary results on asymptomatic and pathological subjects are provided, in terms of the 'ruled surface' formed by sampled IHAs and of their piercing points through the mid-sagittal plane during a prescribed flexion-extension movement of the neck. Author.

4. AUTHOR	Keith-W-S.
INSTITUTION	Division of Neurosurgery, Toronto Western Hospital, Ontario, Canada.
TITLE	"Whiplash"-injury of the 2nd cervical ganglion and nerve.
SOURCE	Can-J-Neurol-Sci 1986 May, VOL: 13 (2), P: 133-7, ISSN: 0317-1671.

5. 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.

6. 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.

7. AUTHOR	Baur-E.
TITLE	(Whiplash injuries of the cervical spine and Swiss insurance against accidents (author's transl)). TT Das Schleudertrauma der Wirbelsaule aus der Sicht der SUVA.
SOURCE	Radiol-Clin (Basel) 1975, VOL: 44 (4), P: 251-64.
ABSTRACT	The indemnity for the consequences of a whiplash injury on the cervical spine by the Swiss Insurance against Accidents is discussed. The number of these cases can be only roughly extimated. We can calculate yearly with about 600 distortions of the cervical spine resulting from motoring accidents. The definition of the whiplash injury is defined on the base of recent German literature. The supposed mechanical assumptions for a lesion of the cervical spine are based mainly on the works of Erdmann (Frandfurt). The relations between the lesion of the cervical spine an the rebound injuries of the skull are discussed. The significance of the preexistent degenerative alterations of the cervical spine in the whiplash injury and the problem of the psychogenic superposition are presented by means of 46 observed cases. Author.