File Name: a case complaint outline template nc rear end cervical injuiries and preexisting injuries .zip
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Acupuncture treatment of whiplash injury. We evaluated by computerized static posturography the postural changes after acupuncture treatment in a group of 27 patients 12 men and 15 women; mean age, Acupuncture was performed by piercing deeply and bilaterally acupuncture points bladder 10 and gall bladder 20 with steel needles that were twirled manually for 20 seconds.
All patients underwent posturographic evaluations before and just after each session of acupuncture. The control group consisted of 25 patients complaining of the same symptoms as those recorded by the study group due to whiplash injury but treated with nonsteroidal anti-inflammatory drugs and myorelaxation or with physiotherapy only.
The data presented in this study revealed a considerable difference between the two groups as regards the reduction of the CE and CER length of the statokinesigram just before each session of acupuncture; the frequency oscillation on the sagittal plane in CER was reduced in the study group, whereas we noticed a progressive increase of its values in the control group.
The high percentage of positive results in whiplash injury patients leads us to advocate acupuncture for balance disorders due to cervical pathology. Cervical vertigo and dizziness after whiplash injury. Whiplash injury is not only limited to neck injury but also brainstem injury that does not involve direct damage to the neck or head. The symptoms of whiplash injury are polymorphous, with the most common complaints being cervical pain, headache and scapulodynia. In otoneurologic studies, magnetic resonance angiography MRA is used for the evaluation of vertebrobasilar hemodynamics in patients who complain of dizziness and vertigo.
It is reported that vertebrobasilar artery insufficiency VBI leads to brainstem and cerebellar ischemia and infarction following cervical manipulation. Here we examined the correlation between vertigo or dizziness and the right and left side difference in vertebral arteries after whiplash injury using MRA. We studied 20 patients who complained of neck pain with vertigo or dizziness after whiplash injury and 13 healthy volunteers as a control.
The side difference in blood flow was 3. Our findings suggest that some subjects with persistent vertigo or dizziness after whiplash injury are more likely to have VBI on MRA. VBI might be an important background factor to evoke cervical vertigo or dizziness after whiplash injury.
The side difference between the two vertebral arteries could cause a circulation disorder in the vertebrobasilar system after whiplash injury. However, the VBI on MRA itself was also seen in the control group, and thus it is not clear whether it is due to whiplash injury in the patient group.
Do head-restraints protect the neck from whiplash injuries? PubMed Central. Over an month period a study was made of all patients presenting to an accident and emergency department who had sustained whiplash as a result of rear-bumper impacts. The patients were analysed with respect to the presence of head-restraints in their vehicles. A significant increase in the incidence of whiplash was found in patients whose vehicles did not have head-restraints fitted. Legislation requiring all passenger cars to have head-restraints fitted as standard would have a major impact in reducing the number of whiplash injuries sustained in rear bumper impacts.
Isometric muscle fatigue of the paravertebral and upper extremity muscles after whiplash injury. Whiplash -associated disorders WAD result from injury of neck structures that most often occur during traffic accidents as a result of rapid acceleration-deceleration. The dominant symptoms manifest in the musculoskeletal system and include increased fatigue. Because of the frequency of whiplash injuries , a simple, cheap and useful diagnostic tool is needed to differentiate whiplash injury from healthy patients or those faking symptoms.
To determine muscle fatigue in patients with whiplash injury in six body positions. Analytical cross-sectional study. Emergency center, university hospital. We studied patients with whiplash injury from vehicular traffic accidents who presented to the emergency center within 6 hours of sustaining the injury.
We determined whiplash injury grade according to the Quebec Task Force QTF classification and measured isometric muscle endurance in six different body positions. Control subjects for each patient were matched by age, gender and anthropomorphic characteristics. Cut-off values were determined to distinguish patients with whiplash injury from controls and for determination of injury grade. QTF grade, time to muscle fatigue in seconds. From September to September , we enrolled 75 patients with whiplash injury and 75 matching control subjects.
In all six positions, the patients with whiplash injury felt muscle fatigue faster than equivalent controls P injury grades in all six positions.
The most efficient position was the highest injury grade, by which Isometric muscle endurance correlated with whiplash injury grade in all six positions P [Medical and legal considerations in whiplash injury ]. Whiplash injury usually occurs in people who suffered an automobile accident, but also occurs as a result of physical assault and other mechanisms.
Diagnosis and initial management of the patient by the emergency physician or orthopedist, and prescribing indications, are taken into account by two forensic intervention specialists.
One of these is the medical officer, who, through analysis of the injury mechanism, establishes a cause-effect relationship and concludes whether the accident suffered by a worker it is related to work or not, determines how long the worker will remain disabled and if the injury caused permanent disability under Federal Labor Law.
The medical examiner by injury classification assists the Public Ministry so that it can frame the crime of injury to the Criminal Code of Federal District. For these reasons a review of medical information about the mechanism of injury , diagnosis, treatment and healing time was performed to help both specialists to standardize their approach in their daily activities.
Anterior longitudinal ligament injuries in whiplash may lead to cervical instability. Although whiplash injuries account for a significant annual cost to society, the exact mechanism of injury and affected tissues remain unknown. Previous investigations documented injuries to the cervical anterior longitudinal ligament in whiplash. The present investigation implemented a comprehensively validated computational model to quantify level-dependent distraction magnitudes of this structure in whiplash.
Maximum ligament distractions approached failure levels, particularly in middle to lower cervical levels, and occurred during the initial phase of head-neck kinematics. In particular, the C5-C6 anterior longitudinal ligament sustained distraction magnitudes as high as 2. Present results demonstrated that anterior structures in the lower cervical spine may be susceptible to injury through excess distraction during the retraction phase of whiplash , which likely occurs prior to head restraint contact.
Susceptibility of these structures is likely due to non-physiologic loading placed on the cervical spinal column as the head translates posteriorly relative to the thorax. Injury to anterior spinal structures can result in clinical indications including cervical instability in extension, axial rotation, and lateral bending modes.
Mitigation of whiplash injury may be achieved by minimizing head retraction during initial stages of whiplash. Early mobilization of acute whiplash injuries. Acute whiplash injuries are a common cause of soft tissue trauma for which the standard treatment is rest and initial immobilisation with a soft cervical collar.
Because the efficacy of this treatment is unknown a randomised study in 61 patients was carried out comparing the standard treatment with an alternative regimen of early active mobilisation. Results showed that eight weeks after the accident the degree of improvement seen in the actively treated group compared with the group given standard treatment was significantly greater for both cervical movement p less than 0.
Headache and musculoskeletal complaints among subjects with self reported whiplash injury. The HUNT-2 study. Background To evaluate the life-time prevalence of self reported whiplash injury and the relationship to chronic musculoskeletal complaints MSCs and headache in a large unselected adult population. Methods Between and , all inhabitants 20 years and older in Nord-Trondelag county in Norway were invited to a comprehensive health survey.
Out of 92, eligible for participation, a total of 59, individuals Among these, 46, Results The total life-time prevalence of self reported whiplash injury was 2. Conclusions Subjects with self reported whiplash injury had significantly more headache and musculoskeletal complaints than those without, and may in part be due to selective reporting. The causal mechanism remains unclear and cannot be addressed in the present study design. Symptoms, disabilities, and life satisfaction five years after whiplash injuries.
Background Chronic whiplash -associated disorders WADs are often associated with social functioning problems and decreased ability to perform previous activities. This may lead to decreased life satisfaction, which is insufficiently studied in the context of whiplash injuries.
In cases of MTBI, the severity and number of symptoms have been suggested to have a diagnostic value. The corresponding importance of symptoms in chronic WAD has not been documented. Most studies of whiplash injuries have focused on neck pain because this is the dominant complaint, while other symptoms are less studied. The frequency of long-term symptoms after whiplash injuries seems to vary.
It is difficult to compare the long-term outcome since the follow-up after whiplash injury in most studies has been rather short.
Therefore, the primary aim of this investigation was to study neck pain and other symptoms, disability, and life satisfaction five years after whiplash injury in a defined population and geographical area.
Methods The study was carried out at a public hospital in northern Sweden and was a cross-sectional survey of patients five years after the injury event in a cohort of whiplash -injured patients. The answers were compared to those of a comparison cohort. Whiplash injuries : is there a role for imaging? Whiplash describes the manner in which a head is moved suddenly to produce a sprain in the neck and typically occurs after rear-end automobile collisions. It is one of the most common mechanisms of injury to the cervical spine.
Although considered by some to be a form of compensation neurosis, evidence suggests that whiplash injuries are real and that they are a potential cause of significant impairment.
Cervical roentgenography and conventional or computed tomography CT may show dislocations, subluxations and fractures in severely traumatized patients, but often fail to determine or visualize the cause for a whiplash syndrome. Magnetic resonance imaging MRI , however, is able to assess different types of soft-tissue lesions related to whiplash injuries. Dynamic imaging may show functional disturbances. Whiplash injuries of the temporomandibular joint in motor vehicle accidents: speculations and facts.
Referring to the temporomandibular joint TMJ of the human mandibular locomotor system, it has been asserted that displacement of the TMJ disc and inflammation of TMJ tissues are the results of acute and indirect trauma to the TMJ; on occasion this is allegedly experienced in motor vehicle accidents and commonly known as a TMJ whiplash injury.
It is postulated that the TMJ whiplash injury is released in the occupant or occupants of a target vehicle when its rear end is impacted by the front end of a bullet vehicle. For the asserted TMJ whiplash manoeuvre and ensuing injury to occur as postulated, the laws of physics and biology would have to be suspended.
Pain thresholds and tenderness in neck and head following acute whiplash injury : a prospective study. Algometry was performed at a distant control site. Focal, but not generalized, sensitization to musculoskeletal structure is present until 3 months, but not 6 months, after whiplash injury , and probably does not play a major role in the development of late whiplash syndrome. Pressure algometry and palpation are useful clinical tools in the evaluation of neck and jaw pain in acute whiplash injury.
What information do patients need following a whiplash injury? The perspectives of patients and physiotherapists. The aims of the present study were to identify information that individuals with whiplash associated disorders WAD need to know in the early stages of recovery and to establish whether there is a difference between what physiotherapists and whiplash -injured patients perceive as important information.
Forty-one participants were recruited 20 whiplash -injured patients, 21 physiotherapists.
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Trial strategy is the overall plan to be executed with the most likely opportunity for success in the case. Trial tactics are the specific tools used to implement the overall trial strategy. Do not become bogged down in tactics so that sight is lost of the overall trial strategy. A single cross-examination that went unusually well will not usually carry the day. Attention must be paid to what, in the large scheme of things, must be accomplished throughout the life of the case to ensure success at the end of the day. Every case is different and so every trial strategy will be different. However, certain universal principles can be applied in every case to lead to the best trial strategy for that particular case.
injury cases get back on their feet and hopes that clients look to him as Mr. ______ was treated for his complaints of a severe headache and mid diagnosed with sprain of ligaments of cervical spine, segmental and somatic dysfunction of Treater distinguished pre-existing conditions from crash injuries.
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One stance was that a relatively small percentage of mTBI patients experience lasting problems for physiogenic i. The second view was that residual problems arising from mTBI are more psychogenic i. Uzzell and Ruff, Camenzuli, and Mueller , for example, were in the former camp, whereas others, including Binder and Larrabee , leaned away from a neurological causation explanation for residual problems, pending more rigorous scientific investigation.
Sample Demand Letter in Car/Truck Accident Case
By Charles R. Gueli, Esq. Most Americans can expect to be involved in three or four car accidents during their lifetime.
Below is an example settlement demand letter we wrote in a truck accident case that we ultimately settled. In some cases, the demand letter is the linchpin that gets the claim resolved. In others, it is a useless appendage that sits atop a pile of medical records and bills. Either way, you have to write the demand package like the case depends on it. Measure twice and cut once: there are a lot of mistakes you can make in putting these letters together. You are going to have a hard time backing away from any position that you take in the demand package for settlement purposes as the case progresses.
Rheumatologists are often called to be independent examiners of injured claimants and and she was told that she suffered soft tissue injuries to her neck, shoulder, and back, The defense added, however, that the plaintiff had a pre-existing For example, in the illustration above, a necessary condition of the rear-end.