[The safety belt: effects on injury patterns of automobile passengers]

Juvenile stroke: cervical artery dissection in a patient after a polytrauma

Dissections of the cervical arteries cause about 20% of total juvenile strokes. Approximately 4% of the carotid artery dissections are due to a (poly)trauma such as car accidents. Despite improved diagnostic facilities, traumatic dissections are often underdiagnosed or diagnosed too late due to a lack of awareness of potential initial signs and symptoms. We report here a case of a delayed embolic stroke after a car accident caused by a dissection of the carotid artery and subsequent pseudoaneurysm. To reduce the long-term morbidity or mortality of multiple trauma patients, an early detection of cervical carotid and vertebral dissections is strictly necessary.

The nosologic status of the whiplash syndrome: a critical review based on a methodological approach

STUDY DESIGN

Empirical studies concerning the whiplash syndrome are reviewed from the point of view of epidemiologic methodology.

OBJECTIVE

To assess the nosologic status of the whiplash syndrome.

SUMMARY OF BACKGROUND DATA

Although a large number of studies concerning the syndrome exist, there is still controversy concerning the existence of the syndrome.

METHODS

The manner in which each study contributes to the validity of the syndrome is determined on the basis of the methodologic design (descriptive, case-control, cohort, and intervention/experimental) of the study.

RESULTS

Whereas the face validity of the syndrome is excellent, the descriptive, construct, and predictive validity are rather poor. In particular, convincing empirical evidence for a causal link (construct validity) between the trauma mechanism and chronic symptoms is sparse.

CONCLUSIONS

Carefully conducted studies designed to assess the degree to which head and nec trauma contribute to the development of chronic pain, particularly head and neck pain, are urgently needed.