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Journal of Neurology and Neurorehabilitation Research | Volume 4
September 03-04, 2019 | London, UK
Spine and Spinal Disorders
4th International Conference on
J Neurol Neurorehabil Res, Volume 4
Whiplash Associated Disease (WAD) is a disease many
people suffering from. More than 75% of the cases are
caused by car accidents in which the car driver, waiting in line
because of a red traffic light or a traffic block, is hit by another
car from behind. In most cases this accident is completely
unexpectedforthedriverinthefrontcar,whichmeansthatthe
neck muscles of this driver were relaxed during the accident.
During the collision the trunk of the driver in the front car is
pushed forward with the head staying behind, resulting in
a sudden and strong stretching of the relaxed anterior neck
muscles. Subsequently, when the front car stops, the body of
the driver is pushed backward leaving the head in an anterior
position resulting in very strong stretching of the posterior
neck muscles. This strong flexion-extension movement often
causes large damage of the neck muscles and of the facet
joints, capsules and ligaments of the upper cervical vertebrae.
These neck muscles and upper cervical facet joints and
ligaments send a large amount of information to the spinal
cord regarding the position of the head in space. In the upper
cervical spinal cord this information is relayed to higher
brain levels of which the mesencephalic periaqueductal gray
(PAG) and adjoining areas are the most important. Other
information regarding the position of the head originates from
the vestibular nuclei and from the visual system. Based on
this information the mesencephalon determines the position
of the head and the eyes. In WAD-patients the damaged
neck muscles and upper cervical vertebrae deliver incorrect
proprioceptive information to thePAG, resulting inamismatch
between this information and the incoming information from
the undamaged vestibular and visual systems. This mismatch
causes balance disturbances, dizziness, headache, and central
hypersensitivity to pain, the common symptoms in WAD
patients. How to correct this mismatch will be discussed. Such
a correctionmight lead to treatments of WAD, a disorder with
anestimatedyearlycostinEuropeofatleast€10.000.000.000.
Speaker Biography
Gert Holstege is a Neuroscientist at University of Groningen in the
Netherlands. He studied Medicines at Erasmus University Rotterdam from
1966 to 1971. He was Neuroscientist at Erasmus University Rotterdam from
1971 to 1987, after which he worked for four years for NASA in Mountain
View,California.Since1990,hehasworkedatUniversityofGroningen,where
he has been a Full Professor of Neuroanatomy since 1993 and Chairman
of the Department of Anatomy and Embryology at Faculty of Medicine.
e:
Gert Holstege
University of Groningen, The Netherlands
The reason why whiplash exists and possible treatments