Whiplash injuries are common sequelae of motor vehicle collisions. Symptoms of whiplash include neck pain, back pain, headaches and pain or paresthesia in the upper limbs. A Life Less common but often change the outcome of cervical lesions are mild traumatic brain injury (TCL). TCL can also be called closed head injury or post-concussion syndrome. Trauma in a motor vehicle collision (MVC) are the most common cause of both fatal and mild brain damage that causes 67% of cases.
MTBI mechanism is thought to stretching or cutting axons. Axonis long, slender projection of a neuron, or nerve cells, which makes the electrical impulses from the neuron cell body. It is associated with a lesion at the expense of individual neurons and the loss of connections between neurons, which can lead to the division of a global strategy of communication between neurons in the brain. Traffic accidents, axonal shear is the result of excessive forces are generated by a rapid change of direction of head acceleration second vehicle attack.
TCL and post-concussion syndrome is often associated with direct trauma to the head. This is not necessarily the case in motor vehicle collisions. The unique strengths generated in these collisions are sufficient to damage brain cells in the absence of direct trauma. Collision speeds of 7-10 km / h, is sufficient to cause symptoms of TCL. In fact, cognitive deficits and emotional TCL are more common in fewer serious injuries than those with major trauma and prolonged loss of consciousness.
MTBI symptoms include headaches, dizziness, nausea, ringing in the ears and blurred vision. Emotional symptoms can include irritability, anxiety, depression and sleep disorders. The typical history of this syndrome is that relatively few symptoms of a hospital or emergency room discharge. The symptoms increase with up to 90 days post-injury. After this, many of the symptoms usually disappear over time. Headaches, dizziness, cognitive problems and generally lasts longer and can lead to chronic wounds.
Since the standard diagnostic techniques such as MRI and CT scans do not help the diagnosis of MTBI is diagnosed through a comprehensive clinic. Open questions after the symptoms of a car accident leads to underestimation of symptoms due to confusion in the patient that the multidimensional nature of the complaint. Medical intake forms, checklist of common symptoms of MTBI. If the number of symptoms checked the doctor should be suspected MTBI. The next step is a clinical distinction between before and after the injury symptoms. A good tool for this application is the Rivermead Post Concussion.
Rivermead test consists of two sections. The first section (RPQ-3) consists of three elements (headache, dizziness and nausea) and the second section (RPQ-13) contains elements, including sleep disturbances, fatigue and a lack concentration. The total score for RPQ-3 lines are potentially 0-12 and is associated with onset of symptoms clusters TCL. If there is a higher score on the RPQ-3, already re-evaluation and closer monitoring is recommended. The RPQ-13 is potentially score 0-52, with higher scores reflecting more severe symptoms of the TCL. The RPQ-13 items associated with a recent cluster of symptoms, although RPQ-3 with symptoms of headache, dizziness and nausea may also be present. The recent cluster of symptoms associated with a greater impact on participation, psychosocial functioning and lifestyle. The Rivermead test should be repeated at 60-90 day intervals. Scores remain high even justify testing a neuropsychologist.
Neuropsychological assessment of TCL consists of a battery of questionnaires and tests designed to describe and quantify changes in cognition, personality, emotional functioning, behavior and monitor the function over time.
Due to the subjective nature of most of the complaints attributed to TCL, the issue of simulation is often associated with these cases. Physicians should be aware of this and to properly document any inconsistencies with the patient's history, activities of daily living and reports from family members. The many social and emotional problems that accompany a motor vehicle collision should also be considered in the equation of diagnosis. The frustration of dealing with police reports, insurance claims and lost work often exacerbate the symptoms TCL.
The literature on whiplash and mild traumatic brain injury (TCL) has disagreements among authors regarding the type and severity of brain damage that can and do occur after a car accident. Despite the disagreements, it appears from the literature that brain damage can result from whiplash. The diagnosis of whiplash injury after MTBI is based on patient history, a specific question about the forms of admission, clinical symptoms, the Rivermead questionnaire and the results of a neuropsychological evaluation. Given the relatively minor accidents can cause brain damage vehicle, often in the absence of direct head trauma, it is essential that practitioners evaluating these cases be aware of TCL as a possible diagnosis.
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