Headaches in the whiplash syndrome

A prospective clinical analysis of headaches in whiplash injury.

To provide a detailed clinical account of the nature, characteristics and natural history of headaches, and to examine their possible relation to the neck injury.

One medicolegal practice in UK.

This study consists of a prospective clinical analysis of headache symptoms in consecutive patients referred to the author for medicolegal assessment of whiplash injury, with no special reference to headaches.

All 80 patients noted neck pain. Headaches were related as a consequence of the accident by 48 patients (60% of the total). The circumstances of injury did not differ from whiplash victims who did not have prominent headache. The headache onset was maximum in the first 24 h after injury. The failure to recall well documented pre-accident headaches in almost one fifth of patients is significant. The common types of headaches were non-specific, generalised, dull, aching pain (25 patients), a mixtures of aching and tightness, and tension type headache. Only three (6%) had migraine without aura.

Post-whiplash headache is a genuine common but short lived affair, constant headaches disappearing within 3 weeks in 85% subjects. In the minority complaining of headache after that period there was no evidence of persisting physical injury, nor of inability to work or other disability caused by headaches.