Intracranial hypotension following motor vehicle accident: an overlooked cause of post-traumatic head and neck pain?

Pain Pract. 2007 Mar;7(1):47-52. doi: 10.1111/j.1533-2500.2007.00111.x.

Abstract

Motor vehicle accidents result in many patients with chronic head and neck pain, some of which meet the criteria for a "whiplash syndrome." The cervical zygapophysial joint synovium, muscular, and ligamentous strains and other anatomical sites are often implicated in the pathophysiology of these cases. Some patients have a characteristic constellation of vague neurological symptoms, often including headache, posterior neck discomfort, dizziness, nausea, and sometimes visual changes. Recently presented research has noted that some patients who have a whiplash-associated disorder have imaging findings consistent with a low-pressure cerebrospinal fluid leak. Some of these patients respond favorably to high-volume epidural blood patch. The following case presentation focuses on the differential diagnosis of a post-traumatic headache syndrome, specific imaging findings, and treatment strategies.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic*
  • Analgesics / therapeutic use
  • Aspirin / therapeutic use*
  • Blood Patch, Epidural
  • Diplopia / etiology
  • Drug Therapy, Combination
  • Female
  • Headache / drug therapy*
  • Headache / etiology
  • Humans
  • Ibuprofen / therapeutic use
  • Intracranial Hypotension / etiology*
  • Intracranial Hypotension / physiopathology
  • Intracranial Hypotension / therapy*
  • Middle Aged
  • Neck Pain / etiology
  • Omeprazole / therapeutic use

Substances

  • Analgesics
  • Omeprazole
  • Aspirin
  • Ibuprofen