Whiplash injury - A medicolegal issue

Whiplash Injury is the most common injury sustained in traffic accidents. On exposure to different forces, multiple neck injuries may occur. Following the injury, many patients suffer from subjective symptoms that may even persist upon completion of medical treatment. As a result, there are serious problems in the objective evaluation of permanent consequences of the injury. The study included 40 randomly selected whiplash injury victims without previous lesions of cervical spine, and 40 equally selected patients with previously confirmed cervical degenerative changes. They all suffered from permanent whiplash injuries and applied for reimbursement for nonmaterial damage to Zagreb Insurance Company during 2001. Sixty-seven per cent of patients underwent continuous treatment for 5-6 months, however, the sequels of whiplash injury persisted in the form of decreased motility of cervical spine, arm paresthesia, vasospasni of vertebral arteries and permanently narrowed visual field. Pathological findings were verified by objective diagnostic methods: functional x-rays of the cervical part of the spinal cord, electromyoneurographic examination of arms, transcramal Doppler sonography of vertebrobasilar arteries, visual field assessment by Goldman method, and clinical examination by medical censor. The treatment of injured patients with previous degenerative changes of cervical spine took a longer time,with a higher level of head and neck motility reduction. Ultimately, in terms of reimbursement, they were conceded a lesser degree of permanent physical damage than those without previous cervical spine lesions.