Karlsborg M, Smed A, Jespersen H, Stephensen S, Cortsen M, Jennum P, Herning M, Korfitsen E, Werdelin L
Department of Neurology, University Hospital of Hvidovre, Copenhagen, Denmark.
Acta Neurol Scand. 1997 Feb;95(2):65-72. doi: 10.1111/j.1600-0404.1997.tb00071.x.
The acute symptoms after whiplash traumas can be explained by the neck sprain, but the pathogenesis of the "late whiplash syndrome" and the reason why only some people have persistent symptoms more than 6 months is still unknown.
Thirty-four consecutive cases of whiplash injury were examined clinically three times; within 14 days, after 1 month and finally 7 months postinjury. In addition, MRI of the brain and the cervical spine, neuropsychological tests and motor evoked potentials (MEP) were done one month postinjury and repeated after 6 months, if abnormalities were found.
The total recovery rate (asymptomatic patients) was 29% after 7 months. MRI was repeated in 6 patients. The correlation between MRI and the clinical findings was poor. Cognitive dysfunction as a symptom of brain injury was not found. Stress at the same time predicted more symptoms at follow-up. All MEP examinations were normal.
In this study, long-lasting distress and poor outcome were more related to the occurrence of stressful life events than to clinical and paraclinical findings.
鞭打损伤后的急性症状可由颈部扭伤解释，但“迟发性鞭打综合征”的发病机制以及为何只有部分人在6个月后仍有持续症状尚不清楚。
连续34例鞭打损伤患者接受了3次临床检查，分别在伤后14天内、1个月后以及最终伤后7个月进行。此外，在伤后1个月进行了脑部和颈椎的磁共振成像（MRI）、神经心理学测试以及运动诱发电位（MEP）检查，若发现异常，则在6个月后重复检查。
7个月后总恢复率（无症状患者）为29%。6例患者进行了MRI复查。MRI与临床检查结果之间的相关性较差。未发现认知功能障碍作为脑损伤症状。同时存在压力预示着随访时会出现更多症状。所有MEP检查均正常。
在本研究中，长期痛苦和不良预后与应激性生活事件的发生比与临床及临床旁检查结果的关系更大。
