Headache in chronic acceleration injury of the cervical spine

Abstract

Some people believe in cervicogenic headaches, others do not - there has been exaggeration on both sides. In the past 10 years the author studied 191 patients for evaluation by a medical expert. 104 of the patients were represented by a lawyer and 26 more were sent by court. 63 of the 191 patients were male, 128 female, so about 2 out of 3 were female. The average age of the men was 41.8 years (24-66) and of the women 37.5 (20-68). All were victims of a road accident. 129 had suffered a rear-end collision, 33 a frontal collision and 27 another type of road accident with whiplash mechanism, but without head trauma. The time elapsed since the accident was on average 4.23 years (1 to 26 years).The author presents the results of a retrospective study of these patients. 174 of the 191 suffered a new headache after the accident. This means that 91% of the whiplash victims with long-standing health problems had a new type of headache after their accident. The great majority (91%) still suffered from headaches in addition to the neck pain and other typical symptoms of whiplash injury. In 71% of those suffering from a new type of headache, the headache was already present the first day after the accident. The headache mostly irradiated from the neck to the frontal and retroorbital region, either bilaterally or mainly on one side. 124 of these 174 persons had their first headache immediately or not later than one day after the accident, 2 in the course of the first week, 9 in the course of one month following the accident and in 39 this information was not available. The characteristics of the pain, their development with time and the treatments applied are presented. Some speculations about the pathophysiology of this type of headache are added.