Acceleration-deceleration cervical injuries

Acceleration-deceleration cervical injuries (commonly known as whiplash) result from sharp hyperextension and flexion of the neck that damages muscles, ligaments, disks, and nerve tissue. The prognosis for this type of injury is excellent; symptoms usually subside with treatment.

Causes

Whiplash commonly results from rear-end automobile accidents. A seat belt keeps a person’s body from being thrown forward, but the head may snap forward, then backward, causing a whiplash injury to the neck. Other causes include roller coasters or other amusement park rides, sports injuries, or punches or shoves.

Signs and symptoms

Although symptoms may develop immediately, they’re often delayed 12 to 24 hours if the injury is mild. Whiplash produces moderate to severe anterior and posterior neck pain. Within several days, the anterior pain diminishes, but the posterior pain persists or even intensifies, causing patients to seek medical attention if they didn’t do so before. Whiplash may also cause dizziness, gait disturbances, vomiting, headache, nuchal rigidity, neck muscle asymmetry, and rigidity or numbness in the arms.

Diagnosis

Full cervical spine X-rays are required to rule out cervical fractures. If the X-rays are negative, the physical examination focuses on motor ability and sensation below the cervical spine to detect signs of nerve root compression.

Treatment

Treatment aims to control symptoms and includes:

❑ a mild analgesic — such as aspirin with codeine or ibuprofen — and possibly a muscle relaxant — such as diazepam, cyclobenzaprine, or chlorzoxazone with acetaminophen

❑ ice or cool compresses to the neck to relieve pain

❑ immobilization with a soft, padded cervical collar for several days or weeks

❑ in severe muscle spasms, short-term cervical traction.

Most whiplash patients are discharged immediately.

Special considerations

Alert In all suspected spinal injuries, assume that the spine is injured until proven otherwise. Until an X-ray rules out a cervical fracture, move the patient as little as possible. Before the X-ray is taken, remove any ear and neck jewelry carefully. Don’t undress the patient; cut clothes away if necessary. Caution him to avoid making movements that could injure his spine.

❑ Teach the patient to watch for possible adverse drug effects; to avoid alcohol if he’s taking diazepam, opioids, or muscle relaxants; and to rest for a few days and avoid lifting heavy objects.

❑ Instruct the patient to return to the hospital immediately if he experiences persistent pain or develops numbness, tingling, or weakness on one or both sides.

Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

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Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.

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More About This Book: Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X

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