Sjaastad Ottar, Fredriksen Torbjörn A, Båtnes Jan, Petersen Hans C, Bakketeig Leiv S
Department of Neurology, St Olavs Hospital, Trondheim University Hospitals (NTNU), Trondheim, Norway.
J Headache Pain. 2006 Feb;7(1):9-20. doi: 10.1007/s10194-006-0270-x. Epub 2006 Feb 20.
In whiplash studies, there may be interpretation difficulties: are post-whiplash findings, when present, a consequence of the whiplash trauma, or did they exist prior to trauma? In the Vågå headache epidemiology study (1995-1997), there was a headache history and detailed physical/neurological findings from the face/head/neck in 1838 18-65-year-old parishioners. In September 2001, four years after the Vågå study, a search through the Health Centre files divulged six cases with whiplash trauma in the intervening period. These parishioners could thus be their own controls. Two females did not develop new complaints. In the four parishioners with apparently new, subjective complaints, i.e., headache, neck pain, and a feeling of stiffness in the neck, there were corresponding findings as regards various parameters: shoulder area skin-roll test, changes in two, possible changes in two; range of motion, neck, changes in two, borderline changes in one; "features indicative of cervical abnormality" ("CF"), changes in all four; the mean, post-whiplash stage value was: 3.6+, against 1.6+ prior to accident (Vågå: only 0.93%, "CF" exceeding 3+). In the two without new complaints, the mean "CF" value was 1.0+. The number of cases is small, but the similarity of the symptoms--and signs--following whiplash injury may suggest an element of organic origin in the whiplash syndrome.
在挥鞭伤研究中,可能存在解读困难:挥鞭伤后出现的症状,若存在的话,是挥鞭伤创伤的结果,还是在创伤之前就已存在?在瓦格头痛流行病学研究(1995 - 1997年)中,对1838名18至65岁的教区居民进行了头痛病史以及面部/头部/颈部详细的体格/神经学检查。2001年9月,即瓦格研究四年后,查阅健康中心档案发现在此期间有6例挥鞭伤病例。这些教区居民因此可以作为他们自己的对照。两名女性没有出现新的症状。在四名明显出现新的主观症状(即头痛、颈部疼痛和颈部僵硬感)的教区居民中,在各项参数方面有相应表现:肩部区域皮肤滚动试验,两项有变化,两项可能有变化;颈部活动范围,两项有变化,一项为临界变化;“提示颈椎异常的特征”(“CF”),四项均有变化;挥鞭伤后阶段的平均值为:3.6 +,而事故前为1.6 +(瓦格研究中:只有0.93%的“CF”超过3 +)。在两名没有新症状的居民中,“CF”平均值为1.0 +。病例数量较少,但挥鞭伤后症状和体征的相似性可能表明挥鞭伤综合征存在一定的器质性因素。