Prospects and Prediction of Post-Traumatic Headache after Whiplash Injury

Approximately 90 % of patients complain about head or neck pain following whiplash injury. These complaints most often resolve within the first few weeks after the accident. However, about 10 - 20 % of the patients develop chronic post-traumatic headache. Can we identify any psychological factors that may contribute to the development of this chronic pain state, or recognise factors that might prevent chronification? To answer these questions, we have conducted a multicentre, prospective study with 21 participating accident and emergency departments. We used different, validated neuropsychological tests: Neck Disability Index (NDI); Kiel Pain Inventory (KSI); Questionaire of pain coping strategy acquisition (FESV); Freiburg Personality Inventory (FPI); Hospital Anxiety and Depression Scale - German Version (HADS-D); and an individual headache diary. Preliminary results point out several possible psychological features that may favour the development of chronic post-traumatic headache following whiplash injury. Whether these changes are solely due to psychological alterations or whether additional underlying structural cerebral changes may also play a considerable role is being investigated in additional MRI examinations.

[1]  J. Olesen.  The International Classification of Headache Disorders , 2008, Headache.

[2]  L. Bakketeig,et al.  Whiplash in individuals with known pre–accident, clinical neck status , 2006, The Journal of Headache and Pain.

[3]  N. Pratt,et al.  Potential risk factors for prolonged recovery following whiplash injury , 2005, European Spine Journal.

[4]  L. Claes,et al.  In vitro low-speed side collisions cause injury to the lower cervical spine but do not damage alar ligaments , 2004, European Spine Journal.

[5]  U. Lindgren,et al.  Psychiatric Morbidity in Patients With Chronic Whiplash-Associated Disorder , 2004, Spine.

[6]  R. Ferrari,et al.  Correlation of clinical findings, collision parameters, and psychological factors in the outcome of whiplash associated disorders , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[7]  R. Ferrari,et al.  From railway spine to whiplash--the recycling of nervous irritation. , 2003, Medical science monitor : international medical journal of experimental and clinical research.

[8]  E. Hendriks,et al.  Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies , 2003, Pain.

[9]  K. Poeck.  Zur neurologischen Begutachtung nach „HWS-Schleudertrauma” , 2002 .

[10]  D. Han,et al.  Vertebrobasilar dissection: A possible role of whiplash injury in its pathogenesis , 2002, Neurological research.

[11]  Samy Suissa,et al.  The relation between initial symptoms and signs and the prognosis of whiplash , 2001, European Spine Journal.

[12]  Å. Nygren,et al.  Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. , 2000, The New England journal of medicine.

[13]  G. Stranjalis,et al.  The Physician Survey on the Postconcussion and Whiplash Syndromes in Greece , 2000, Headache.

[14]  W. Spitzer,et al.  Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: redefining "whiplash" and its management. , 1995, Spine.

[15]  R. Evans.  The postconcussion syndrome and the sequelae of mild head injury. , 1992, Neurologic clinics.

[16]  S. Mior,et al.  The Neck Disability Index: a study of reliability and validity. , 1991, Journal of manipulative and physiological therapeutics.

[17]  S. Mandel.  Minor head injury may not be 'minor'. , 1989, Postgraduate medicine.

[18]  R. Janzen.  Schleudertrauma der Halswirbelsäule , 1966, Langenbecks Archiv für klinische Chirurgie.

[19]  A. Walker.  CHRONIC POSTTRAUMATIC HEADACHE , 1965, Headache.

[20]  G. Bannister,et al.  Whiplash injury. , 2009, The Journal of bone and joint surgery. British volume.

[21]  B. Gerdle,et al.  Coping in patients with chronic whiplash-associated disorders: a descriptive study. , 2004, Journal of rehabilitation medicine.

[22]  S. Suissa.  Risk factors of poor prognosis after whiplash injury. , 2003, Pain research & management.

[23]  M. Alexander.  The evidence for brain injury in whiplash injuries. , 2003, Pain research & management.

[24]  L. Alfredsson,et al.  Occupant- and crash-related factors associated with the risk of whiplash injury. , 2003, Annals of epidemiology.

[25]  W. Castro,et al.  No stress--no whiplash? Prevalence of "whiplash" symptoms following exposure to a placebo rear-end collision. , 2001, International journal of legal medicine.

[26]  H. Göbel,et al.  Therapie des posttraumatischen Kopfschmerzes nach Schädel-Hirn-Trauma und HWS-Distorsion , 1998, Der Schmerz.

[27]  M. Keidel.  Der posttraumatische Verlauf nach zervikozephaler Beschleunigungsverletzung. Klinische, neurophysiologische und neuropsychologische Aspekte , 1995 .

[28]  Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. , 1988, Cephalalgia : an international journal of headache.