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At least 19 recordsLinked to original sources
PubMed1979

[Psychiatric and postsurographic approach in the study of post-concussion syndromes following head or whiplash injuries. Correlation and additional aspects].

Purpose of this paper is to point out the interest in case of post-concussional syndroma following an head or whiplash injury to practice both: a posturographic examination objectiving the functioning of the different sensori-motor systems who maintain the body equilibrium giving an approach of the possibility of an organic etiology, psychiatric one giving the psychogenic aspect. Different therapeutics are proposed in regard of this double approach. Four cases illustrate this purpose.

Adult↗
PubMed1977

Thoracic outlet syndrome in whiplash injury.

Thirty-five cases of thoracic outlet syndrome complicating whiplash or cervical strain injury were studied. Thirty cases had confirmation by the demonstration of slowed ulnar nerve conduction velocity (UNCV) through the thoracic outlet. Two distinct groups of patients were found. An acute group, seen an average of 3 1/2 months post injury, had severe neck pain with often mild or incidental thoracic outlet syndrome. A chronic group, with symptoms persisting more than 2 years after cervical injury, often had thoracic outlet symptoms as the predominant complaint. This study suggests that the arm aches and parethesias seen in association with both acute and chronic cervical strain injury are most often secondary to thoracic outlet syndrome.

Adult↗
PubMed1976

[EEG after so-called whiplash injury of cervical vertebral column (cervicocephalic acceleration trauma)].

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.

Accidents, Traffic↗
PubMed1977

[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)].

We compared two groups of patients with whplash 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.

Adult↗
PubMed1977

[Multiple fractures of the atlas with delayed fatal thrombosis of vertebral artery following "whiplash" injury of the neck (author's transl)].

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.

Accidents, Traffic↗
PubMedDate not supplied

Acute cervical strain. Evaluation and short term prognostic factors.

An independent examiner evaluated 179 consecutive private ambulatory litigant patients with soft tissue neck injuries (whiplash) from automobile injuries. Treatment of all patients consisted of neck and shoulder exercises with the exclusion of cervical collars, cervical traction and hospitalization. Forty-three patients had intermittent cervical traction in addition to the exercises. All patients were encouraged to resume their usual work and other activities. The presence of interscapular or upper back pain prognosticated a less favorable result. The average length of treatment was 7.4 weeks. Thirty-seven per cent of the patients with asymptomatic; 16 per cent showed no significant recovery. Older patients recovered as well as younger patients. There was no relation between X-ray findings of flattening or reversal of the cervical lordotic curve and the degree of recovery.

Adult↗
PubMed1975

Neurotological studies on the role of the sympathetic nervous system in the formation of traumatic vertigo of cervical origin.

To test the validity of the hypothesis that irritation of the cervical sympathetic nerves is a cause of hypertonicity of the cervical soft supporting tissues, especially the deep nuchal muscles, and that this hypertonicity is a cause of traumatic vertigo of cervical origin, we examined 44 vertigo cases with whiplash injury by testing equilibrium function and EMG discharges from the neck before and after administration of drugs affecting the sympathetic receptors. The results obtained were as follows: 1. Administration of iso-proterenol (beta-receptor stimulant) caused a significant increase in the EMG's from the injured neck muscles, in parallel with increased impairment of the righting reflex. The blindfolded vertical writing test showed the appearance or intensification of ataxia or deviation in writing when this drug was given. In contrast, administration of propranolol (beta-receptor depressor) had the opposite effects on the EMG's, the righting reflex and blindfolded vertical writing. Furthermore, the resulting changes in the EMG's and equilibrium functions were parallel with alterations in subjects' complaints, i.e., increase or decrease in neck pain and vertigo. 2. Administration of drugs affecting the alpha receptors, such as noradrenaline (alpha-receptor stimulant) and phentolamine (alpha-receptor depressor) had no appreciable effect on the EMG's, equilibrium function or the subjects' complaints. These results show that in vertigo due to whiplash injury hypertonicity of the cervical erector muscles can be induced sympathetically, and that this hypertonicity is based on over-excitement of beta receptors in the injured neck muscles, which results in vertigo of cervical origin.

Adolescent↗
PubMed1978

Cervico-occipital pain and its surgical treatment: the myth of the bony millstones.

The proposal was made in 1949 that occipital neuritis/neuralgia was frequently of traumatic origin. The hypothesis was advanced that the C2 sensory root lay unprotected between the lateral masses of the atlas and axis and was vulnerable to squeezing on extreme extension or rotation of the head. This conjecture converted a hitherto banal neurologic affliction into the sequela of a banal trauma. Hence, it has been exploited in the diagnosis and treatment of whiplash injuries as well as for headaches of unknown origin. Evidence is presented that the original anatomic proposition was erroneous and that the C2 root is not exposed and is not vulnerable. Indeed, a survey of the "worst" traumatic and pathologic disruptions of the craniospinal junction shows that although they would be expected to injure the C2 root, in fact, they do not. The theory as well as the operations based upon it, particularly intradural section of the C2 root, should be abandoned.

Cervical Vertebrae↗
PubMed1975

Lumbomuscular proprioceptive reflexes in body equilibrium.

To evaluate the role of reflexes related to the lumbar proprioceptors in maintenance of body equilibrium, changes in equilibrium function of the eyes and body were observed after unilateral procainization of the lumbar erector muscles. Observations were made on normal subjects and vertigo cases with lumbar pain after whiplash injury using various equilibrium tests. The results obtained were as follows: (1) On unilateral procainization of the lumbar erector muscles of normal subjects, eye nystagmus and disturbances of the righting reflex developed. Simultaneously, changes in drift reactions of the lower limbs were detected by the stepping test. Namely, in many of the subjects examined the direction of stepping deviation became quite different from that before procainization, and stepping after procainization tended to show slight or moderate ataxic features, associated with a sensation of unsteadiness. (2) When procaine was injected unilaterally into tender spots in the lumbar erector muscles of traumatic vertigo cases, spontaneous eye nystagmus and disturbances of the righting reflex decreased. Simultaneously, significant changes in the drift reactions of the lower limbs were observed in many of the cases examined. Namely, the direction of deviation became the opposite of that before procainization and ataxia in walking almost disappeared with reduction in vertigo. The following conclusions were drawn from these findings: (1) The effects of procaine on equilibrium of normal subjects are in sharp contrast to its effects on equilibrium of traumatic vertigo cases. Findings in the former might be due to increased imbalance between the activities of the right and left lumbar proprioceptors, while those in the latter might be due to decreased imbalance between the two. (2) These findings support the view that from the standpoint of body equilibrium, there are two phases of the proprioceptive reflex, and that Fukuda's concept of "two phases of the labyrinthine reflex, i.e., a stage of disturbance and a stage of coordination", can be applied to interpretation of the proprioceptive reflex of lumbar origin.

Adult↗