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Cervical Neck StrainAka: Cervical Neck Sprain, Whiplash

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  1. Symptoms: Collison injury in Contact Sports
    1. Sensation of "jammed neck" for days to weeks
  2. Symptoms: Whiplash
    1. Neck pain
    2. Headache
    3. Loss of concentration
    4. Arm Paresthesias (24%)
    5. Dizziness (24%)
    6. Fatigue (19%)
  3. Signs: Red flags suggestive of serious injury
    1. Asymmetry of rotation
    2. Decreased cervical range of motion
    3. Pain over single spinous process
    4. Unrelenting neck pain
    5. Weakness or paralysis
    6. Loss of movement or bladder function
    7. Violent axial loading or rotation mechanism of injury
  4. Signs: Limited Cervical Sprain
    1. Limited Range of Motion
      1. No pain
      2. No Paresthesias
      3. No radiculopathy
    2. Normal Neurologic Exam
  5. Radiology: C-Spine XRay
    1. Loss of normal cervical lordosis with neck spasm
    2. Obtain flexion and extension views
      1. Rule-out instability
    3. Abnormal translatory displacement
      1. Posterior translation > 3.5 mm adjacent vertebrae
  6. Radiology: C-Spine MRI
    1. Not indicated if neurologic changes absent
    2. References
      1. Ronnen (1996) Radiology 201:93
  7. Management
    1. Avoid home use of soft cervical collar for treatment
      1. Prolonged immobilization slows healing
    2. Early active range of motion of neck speeds healing
      1. Rotational Exercises 10 times per hour
      2. Start as soon as tolerated
      3. Continue for first 4 days
    3. Early high dose Corticosteroid (within first 8 hours)
      1. Initial study shows long-term benefit
  8. References
    1. Eck (2001) Am J Med 110:651

Whiplash Injuries (C0043145)

Definition (MSH)Hyperextension injury to the neck, often the result of being struck from behind by a fast-moving vehicle, in an automobile accident. (From Segen, The Dictionary of Modern Medicine, 1992)
ConceptsInjury or Poisoning (T037)
ICD9847.0
MSHD014911
EnglishAcceleration-deceleration injury of neck, INJ WHIPLASH, WHIPLASH, WHIPLASH INJ, Whiplash Injuries, Whiplash Injury, Whiplash injury to neck
Spanishesguince cervical agudo, estrema cervical agudo, lesion traumatica del cuello por hiperflexion - hiperextension
Parent ConceptsNeck Injuries (C0027531), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesCOSTAR, CSP, LCH, MEDLINEPLUS, MSH, MTHICD9, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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