[Cerebral findings following cervical spine distortion caused by acceleration mechanism (whiplash injury). Assessment of current diagnostic methods in nuclear medicine].
In any grade of distortion of the cervical spine as a result of acceleration forces in addition to cervical symptoms cerebral symptoms like headache, vertigo, auditory disturbances, tinnitus, disturbances in concentration and memory, difficulties in swallowing, impaired vision and temporo-mandibular dysfunctions may appear. These symptoms can persist and become invalidating. Cerebral single-photon emission tomography (SPECT) and positron emission tomography (PET) enable new diagnostic horizons for neurotraumatology. In this article we summarize the actual findings of these nuclear medical methods in neuropsychologically deficient patients with distortion of the cervical spine as a result of acceleration forces. Especially the latest results of the group of Basle (University Hospital Basle, Clinic of Rehabilitation Rheinfelden, Switzerland) are illustrated. This group found parieto-occipital hypoperfusion by relative quantitation using SPECT and bicisate (Neurolite, ECD). A first pilot study using PET and F-18-fluoro-deoxyglucose (FDG) could verify the above observation. The group's working hypothesis is that parieto-occipital hypoperfusion may be caused by activation of nociceptive afferences from the upper cervical spine. A critical approach to interpreting new functional methods and, on the other hand, openness in new scientific findings may contribute to answering the lasting controversial medico-legal discussion with more objectivity.
Otte
A
A
Institut für Nuklearmedizin, Universitätskliniken, Kantonsspital Basel.
Ettlin
T M
TM
Fierz
L
L
Kischka
U
U
Muerner
J
J
Högerle
S
S
Bräutigam
P
P
Mueller-Brand
J
J
D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014911:Whiplash Injuries / Q000150:complications*