MRI of cerebrum and cervical columna within two days after whiplash neck sprain injury

Borchgrevink, Grethe E.; Smevik, Olaug; Haave, Irma; Haraldseth, Olav; Nordby, A.; Lereim, I

doi:10.1016/s0020-1383(97)00027-2

Cited by 81 publications

(47 citation statements)

References 16 publications

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“…It is possible that signs of minor tissue damage visible on MRI could vanish before the MRI examinations were performed. However, in one previous study MRI was performed within 2 days after a whiplash injury and no signs of acute injury were seen [4]. Moreover, six of seven cases with traumatic findings in the present study had MRI performed between eight and 22 days after the injury.…”

Section: Discussioncontrasting

confidence: 50%

“…Also, after 1 year it was observed that considerable headache was more frequent in the group with traumatic findings (OR 2.8; 95 CI 0. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] and this group had a higher median headache intensity (Table 6). These above mentioned associations were not significant and the group did not differ otherwise from other participants ( Table 7).…”

Section: Associations Between Mri Findings and Outcomementioning

confidence: 99%

“…To explore the biological component of neck pain following whiplash injuries, studies of magnetic resonance imaging (MRI) have been performed in order to visualise potential damage to the cervical spine [3,4,8,17,[21][22][23]29]. Generally, very few identifications of traumatic lesions have been described in the acute phase after whiplash injuries and findings do not seem to be associated with the prognosis [4,17,29].…”

mentioning

confidence: 99%

“…Generally, very few identifications of traumatic lesions have been described in the acute phase after whiplash injuries and findings do not seem to be associated with the prognosis [4,17,29]. In previous trials, most findings were signs of pre-existing degeneration [3,4,29], which has been observed to be associated with an increased risk of long-lasting symptoms [4,5,29].…”

mentioning

confidence: 99%

“…It seems that standard MRI is not the answer to finding the aetiology of WAD, but existing results are based upon small trials [3,4,8,17,29], and only large prospectively followed series can potentially identify MRI findings that are clinically relevant in subgroups of patients. The objective of this trial was to assess (1) the predictive value of standard cervical MRI and (2) the value of repeating MRI after 3 month including sequences with flexion and extension of the cervical spine in a large consecutively enrolled patient population who had been exposed to whiplash injuries.…”

mentioning

confidence: 99%

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Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

et al. 2008

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Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rearend or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5-6 and C6-7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis.

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Section: Discussioncontrasting

confidence: 50%

Section: Associations Between Mri Findings and Outcomementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

et al. 2008

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Associations between brain morphology and motor performance in chronic neck pain: A whole‐brain surface‐based morphometry approach

Pauw

Coppieters

Caeyenberghs

et al. 2019

Human Brain Mapping

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Changes in brain morphology are hypothesized to be an underlying process that drive the widespread pain and motor impairment in patients with chronic neck pain. However, no earlier research assessed whole‐brain cortical morphology in these patients. This case–control study assesses group‐differences in whole‐brain morphology between female healthy controls (HC; n = 34), and female patients with chronic idiopathic neck pain (CINP; n = 37) and whiplash‐associated disorders (CWAD; n = 39). Additionally, the associations between whole‐brain morphology and motor performance including balance, strength, and neuromuscular control were assessed. Cortical volume, thickness, and surface area were derived from high resolution T1‐weighted images. T2*‐weighted images were obtained to exclude traumatic brain injury. Vertex‐wise general‐linear‐model‐analysis revealed cortical thickening in the left precuneus and increased volume in the left superior parietal gyrus of patients with CINP compared to HC, and cortical thickening of the left superior parietal gyrus compared to HC and CWAD. Patients with CWAD showed a smaller cortical volume in the right precentral and superior temporal gyrus compared to HC. ANCOVA‐analysis revealed worse neuromuscular control in CWAD compared to HC and CINP, and in CINP compared to HC. Patients with CWAD showed decreased levels of strength and sway area compared to CINP and HC. Partial correlation analysis revealed significant associations between the volume of the precentral gyrus, and neuromuscular control and strength together with an association between the volume of the superior temporal gyrus and strength. Our results emphasize the role of altered gray matter alterations in women with chronic neck pain, and its association with pain and motor impairment.

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Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

Farrell

Smith

Hancock

et al. 2019

Magnetic Resonance Imaging

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Background There is uncertainty regarding the clinical significance of findings on MRI in patients with whiplash associated disorder (WAD) or nonspecific neck pain (NSNP). Purpose To compare the presence of cervical spine MRI findings in people with WAD or NSNP with pain‐free controls. Study Type Systematic review and meta‐analysis. Population Adults with WAD (n = 994), NSNP (n = 715), or pain‐free controls (n = 2323). Field Strength 0.5T, 1.5T, and 3.0T. Assessment Medline, EMBASE, CINAHL, Web of Science, SCOPUS, and Cochrane CENTRAL databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Overall quality of the evidence from meta‐analysis was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation approach. Statistical Tests Meta‐analysis was performed using a random‐effects model to calculate odds ratios or standard mean differences (SMDs) for binary and continuous data. Results In total, 31 studies were included (eight comparing acute WAD to controls, 14 comparing chronic WAD to controls, 12 comparing chronic NSNP to controls) comprising 4032 participants. Rectus capitis posterior major cross‐sectional area was smaller in people with chronic NSNP than controls (two studies: SMD –1.18 [95% confidence interval [CI] –1.65, –0.71]). The remaining meta‐analysis comparisons showed no group differences in MRI findings. The quality of evidence was mostly low due to small sample sizes and high heterogeneity. Data Conclusion Given the typically low‐quality evidence, definitive conclusions cannot be drawn on the presence of MRI findings in individuals with WAD or NSNP compared with pain‐free controls. Level of Evidence: 3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018.

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MRI of cerebrum and cervical columna within two days after whiplash neck sprain injury

Cited by 81 publications

References 16 publications

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

Associations between brain morphology and motor performance in chronic neck pain: A whole‐brain surface‐based morphometry approach

Cervical spine findings on MRI in people with neck pain compared with pain‐free controls: A systematic review and meta‐analysis

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