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Headaches Caused by Whiplash

Post traumatic headaches, or headaches caused by whiplash is the second most common symptom of whiplash after neck pain. There are 5 different types all caused by whiplash, each with their own set of symptoms, prognoses, and treatments, making getting to the root of the issue extremely important.

Cervicogenic Headache
While it sounds technical, this is just a headache that arises from the cervical spine.

Occipital Neuralgia
This is a specific type of cervicogenic headache that involves damage or pressure on the occipital nerve. It can be caused by a direct blow to the suboccipital region or by an entrapment of a group of nerves. Specifically, in whiplash trauma, forcible bending of the neck occurs when the head is thrown forward by accelerating/deaccelerating forces. This sort of motion can put a strain on the greater occipital nerve, which can in turn entrap the nerves causing headaches.
Another source of potential nerve damage in this area is the crushing of the C2 spinal roots. The ganglia, or nerves, of the C2 spinal roots are exposed on the vertebral arch of the axis. In this position, they are vulnerable to crushing during forced hyperextension of the head. A study done confirmed this and stated the features of the C2 ganglion may predispose to its vulnerability to compression.

Myofascial Headache
Most headache pains are attributed to myofascial trauma, or injuries of the muscled contraction type. There are a few common issues in diagnosing these: 1. The pain associated with them may originate in a variety of places including the head, neck, and even lower back and 2. They can cause referred pain in the occipital region of the head where there are many delicate structures and swelling or spasms of the muscles can affect the occipital nerve, leading to pain. This causes Myofascial headaches and Occipital Neuralgia to be misdiagnosed as one another.

Temporomandibular Joint Dysfunction
Commonly known as “TMJ” or “Lock Jaw”, this injury is documented thoroughly as a sequela of whiplash, but is often overlooked as a source of headaches post trauma. Headaches occur due to muscular tension in the jaw, causing referred pain to other parts of the head.

Migraines
A poorly understood condition, many doctors are hesitant to attribute migraines to post traumatic events. The origins of migraines are not agreed upon, but one study suggested neck pain or stiffness is a manifestation of extracranial involvement during all phases of a migraine episode. As a result, migraines are associated with whiplash due to the movement and trauma of the neck. Furthermore, studies are showing migraines can also be caused by chronic low back pain, dysfunctional patterns of muscle use, and development of painful muscles in the back and neck – all of which can be caused by whiplash.

Mild Traumatic Brain Injury
Headaches are the most common neurological symptom following minor closed head injuries. Researchers have found it is due in part to decreased blood flow to the head in post-traumatic patients.

Other Headaches
Vascular Headaches – One study found in post-traumatic injury patients, their cerebral circulation is slowed for months and even years following a traumatic event that causes a mild head injury
Analgesic Rebound Headaches
Overuse of pain medications can cause headaches and some pain medications have headaches as a side effect
Treatment
Because untreated headaches can lead to more severe symptoms, treatment in all cases of post traumatic headaches is important. While conservative treatment such as pain medication, massage, and chiropractic manipulation of the area treat most headaches, in some instances, surgery to relieve nerves may be necessary.

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