[Characteristics of the innervation of the head and neck]

Innervation of the head and neck differs from other regions of the body in certain respects. In particular, besides the external cuneate nucleus, thick-calibre neck muscle afferents project directly, to the vestibular nuclear complex. This projection is most prominent in segments C2 and 3 and is sparse or absent in more caudal segments. Thus, proprioceptive neck muscle afferents gain direct access to vestibulospinal, vestibulooculomotor and other secondary or even higher order vestibular neurons that receive labyrinthine input. Proprioceptive input via indirect spinovestibular pathways is also most prominent from C2 and 3 compared to more caudal levels. Likewise, thin calibre, mainly nociceptive afferents from cervical segments are channelled via the parabrachial nuclei in the rostral pons to limbic structures different from the targets of thoracolumbar afferents. It is tempting to consider these neuroantomical peculiarities relevant for the pathogenesis of the puzzling symptoms after whiplash injury.