Traumatic neck injury is challenging to manage, as there are many structures placed in the neck, namely the airway, esophagus, major blood vessels, spinal cord, and nerves. The structures most susceptible to injury are the larynx and trachea [1]. Neck trauma is thus an emergency and can be rapidly lethal, despite a possible lack of outward signs indicating a serious injury.

Severe volume depletion and shock may result from laceration of blood vessels in the neck. Furthermore, neurological consequences may be the result of severing of vessels that supply the brain and spinal cord, such as the common carotid and vertebral arteries [2]. Bleeding from the carotid artery may lead to contralateral hemiparesis, respiratory distress, hematoma formation, and altered level of consciousness [3]. The jugular vein may also be injured, leading to hypovolemia.

The other immediately life threatening injury is collapse or occlusion of the airway. Airway injuries may be evidenced by a sucking neck wound, subcutaneous emphysema, dyspnea, and stridor. Drooling, hemoptysis, and hoarseness may also be present [4] [5] [6].

Pharyngoesophageal injury may present with any of the following: bleeding from the mouth or nasogastric tube if inserted, dysphagia, and neck stiffness [7].

Spinal cord or brachial plexus damage may also lead to numerous neurological signs such as Brown-Séquard syndrome, urinary and rectal sphincters dysfunction, and neurogenic shock. Cranial nerves dysfunction out may also be present.

Signs and symptoms are sometimes separated into hard and soft. Hard symptoms place the patient in the immediate danger and require emergent surgical management. These can include severe bleeding and airway obstruction. Soft signs require careful monitoring and include dyspnea, focal neurological deficits, and hemoptysis.

• Neck Pain

  Neck Injury Whiplash is one type of neck injury. Any type of injury to the neck that causes pain, swelling, a lump in the neck or inflammation can be considered a neck injury. [sharecare.com]

  Neck Pain Tip 4: Move It Research is showing that exercise is an effective way to treat neck pain. [webmd.com]

  Read more on myVMC – Virtual Medical Centre website Neck Pain - Pain Conditions - painHEALTH Learn about neck pain as a musculoskeletal pain condition to identify how you can approach neck pain in your co-management treatment plan Read more on painHEALTH [healthdirect.gov.au]

  Consider other serious causes of neck pain. See separate Neck Pain (Cervicalgia) and Torticollis article. [patient.info]

• Torticollis

  See All 2 Answers 1 Answer A Torticollis, also called wryneck, is a condition that causes short, tight neck muscles. [sharecare.com]

  […] types, including: Neck sprain Pinched nerve (cervical radiculopathy) Neck muscle or ligament strain Osteoarthritis or rheumatoid arthritis Herniated disc Sports injury (concussion) Automobile accident (whiplash) Impact injury from a fall Congenital torticollis [baylorarlington.com]

  Upper back and neck injuries are relatively rare in sport and more often occur from activities of daily living, such as waking up with a wry neck (torticollis). [sportsinjuryclinic.net]

  See separate Neck Pain (Cervicalgia) and Torticollis article. [patient.info]

• Upper Back Pain

  Tight muscles A lot of pain that occurs in the upper back and neck is due to tight muscles in the neck, shoulders and upper back. We look at the symptoms, causes and possible treatment options in more detail. [sportsinjuryclinic.net]

• Cervical Osteoarthritis

  If the forces are great enough, or if there is a predisposing fragility of the spine as in the aged with cervical osteoarthritis, fractures may occur and bony fragments contribute to cord damage. [dartmouth.edu]

• Headache

  There are no specific headache features known to distinguish the types of 5. Headache attributed to trauma or injury to the head and/or neck from other headache disorders; most often these resemble 2. Tension-type headache or 1. Migraine. [ichd-3.org]

  Packard RC, Ham LP: Pathogenesis of posttraumatic headaches and migraine: a common headache pathway ? Headache 1997, 37 :142–152. PubMed CrossRef Google Scholar 9. MacNab I: Acceleration injuries of the cervical spine. [link.springer.com]

  Headaches, dizziness, and blurry vision can also result from whiplash. [sharecare.com]

• Stroke

  Suffering an injury to the head or neck increases ischemic stroke risk three-fold among trauma patients younger than 50, according to research presented at the American Stroke Association's International Stroke Conference 2014. [sciencedaily.com]

  The 4-week stroke incidence was 0.04% (95% CI 0.03-0.05%) (Figure: Kaplan-Meier stroke failure function and 95% CI). The majority of ischemic strokes occurred early after trauma, with 40% on the day of the trauma. [stroke.ahajournals.org]

  If the stroke is large or involves the part of the brain that controls breathing or consciousness, it may be fatal. [insideradiology.com.au]

  Circulation (cont) Assess for “Hard” signs of vascular injury Pulsatile bleeding or haematoma Expanding haematoma Shock + ongoing bleeding Absent pulses Neurovascular symptoms- stroke/TIA symptoms Thrills, bruits 41. [slideshare.net]

  "The presentation is often asymptomatic; the idea is to treat before they get a stroke," he said. [auntminnie.com]

• Meningism

  They are usually the result of transection of the middle meningeal artery by a skull fracture that passes through the middle meningeal groove. [dartmouth.edu]

  […] rheumatoid arthritis Herniated disc Sports injury (concussion) Automobile accident (whiplash) Impact injury from a fall Congenital torticollis (twisted neck) Spondylosis (cervical disc degeneration) Ankylosing spondylitis Spinal fracture Tumors Infection (meningitis [baylorarlington.com]

  Meningitis or meningism due to systemic infection. [patient.info]

  A stiff neck can occasionally be a symptom of another condition, such as meningitis, although this would feature other symptoms such as a temperature, nausea or vomiting. [sportsinjuryclinic.net]

  In cases of frontobasal fractures with CSF fistula, nasal intubation has not been found to be associated with meningitis. 31 Neck Trauma with Extrinsic Airway Compression Airway manipulation might dislodge a hematoma and thus increase bleeding and/or [anesthesiology.pubs.asahq.org]

• Neck Stiffness

  With whiplash, the cervical vertebrae in the neck become strained or sprained because the neck suddenly extended and flexed after a rapid acceleration or deceleration. Symptoms include neck stiffness and pain, dizziness and headache. [sharecare.com]

  Pharyngoesophageal injury may present with any of the following: bleeding from the mouth or nasogastric tube if inserted, dysphagia, and neck stiffness. [symptoma.com]

  Other symptoms of whiplash may include the following: Neck stiffness Injuries to the muscles and ligaments (myofascial injuries) Headache and dizziness (symptoms of a concussion) Difficulty swallowing and chewing and hoarseness (could indicate injury [spineuniverse.com]

  […] at the back of the neck, muscles spasms and pain in your upper shoulder, neck stiffness, and/or numbness, weakness, or tingling in your arm. [verywell.com]

  Long term neck-related morbidity is a well reported complication of traumatic events resulting in nonbony cervical spine injury, and commonly manifests in neck pain, decreased range of movement, neck stiffness, headache, vertigo, persistent minor neurologic [racgp.org.au]

The initial assessment of traumatic neck injury should involve a primary trauma survey. It is important to obtain information about the mechanism of injury and the patient condition between injury and presentation. Loss of consciousness and time of injury should be specifically inquired after. Successive physical examinations are necessary, as some signs of traumatic neck injury emerge after some delay. Full blood count, crossmatching, urea, and electrolytes should be requested, as a baseline for all trauma cases. Drug and alcohol screening tests may also be obtained.

Imaging is essential for traumatic neck injury, in particular, computed tomography (CT) scanning. Care should be taken, however, as radiological studies should not be carried out first if the patient needs emergency intervention. CT is the preferred technique as it details both bone and soft tissue injury and has a high sensitivity and specificity [8] [9]. Furthermore, CT may clearly show injuries that have minimal or absent physical signs.

X-rays of the cervical spine are routine. Chest X-rays are indicated if there is an injury at the base of the neck or if chest injury is suspected too. Possible findings are hemothorax or pneumothorax or pneumomediastinum.

Further studies are done according to physician discretion and health facility regulations. These include magnetic resonance imaging (MRI), Doppler ultrasound, angiography (CT or conventional), and endoscopy [10] [11].

On the treatment side, the Second Edition reflects the impressive advances in pharmacological approaches to migraine. [books.google.com]

Treatment Fortunately, whiplash is treatable and most symptoms resolve completely. Initially, whiplash is treated with a soft cervical collar. This collar may need to be worn for 2 to 3 weeks. [spineuniverse.com]

Read more on Better Health Channel website Neck pain: treatment - myDr.com.au Treatment for neck paindepends on the cause and how severe it is. [healthdirect.gov.au]

Treatment Describe emergency department treatment options and summarize any further definitive treatment provided by subsequent services. [cdemcurriculum.com]

Future Directions in Treatment Future improvements in the treatment of post-traumatic kyphosis are likely to lie in techniques that improve the rate at which fusions heal, according to Dr. Rawlins. [hss.edu]

It includes diagnosis and management of head and neck injury with additional chapters on prognosis and special conditions including head injury in sport, the elderly, children, pregnant women, penetrating head injury, spine and spinal cord injury and [books.google.com]

Treatment and prognosis Treatment of neck injury depends on the severity of injury and the zones of the neck which are involved. Previously, zone 2 injuries penetrating the platysma were thought to require immediate surgical exploration. [radiopaedia.org]

Prognosis The prognosis of whiplash injury is variable and obviously depends on the severity and grade of the whiplash injury. [patient.info]

However, Zone II injuries also have the best prognosis because there’s a larger areas of exposure, allowing for easier proximal and distal control. The incidence of penetrating neck trauma is 0.55-5% of all traumatic injuries. [emdocs.net]

Unfortunately, the vast majority of medical professionals do not recognize or understand the appearance, etiology, or problems associated with M معاينة هذا الكتاب » [books.google.com]

Schwartzman RJ, Grothusen J, Kiefer: Neuropathic central pain: epidemiology, etiology, and treatment options. [link.springer.com]

J Craniofac Surg. (2015). 26 108–12 [Article] [PubMed] Rallis, G, Stathopoulos, P, Igoumenakis, D, Krasadakis, C, Mourouzis, C, Mezitis, M Treating maxillofacial trauma for over half a century: How can we interpret the changing patterns in etiology and [anesthesiology.pubs.asahq.org]

Epidemiology Head injuries are far more common among children than spine injuries, and spine injuries are more frequent among adults than children. [pedsinreview.aappublications.org]

A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med. ‎ [books.google.it]

Schwartzman RJ, Grothusen J, Kiefer: Neuropathic central pain: epidemiology, etiology, and treatment options. [link.springer.com]

Trauma epidemiology, mechanisms of injury, and prehospital care. Essentials of Trauma Anesthesia. (2012). [anesthesiology.pubs.asahq.org]

Migraine: Manifestations, Pathophysiology, and Management, Second Edition, is a much expanded, updated monograph that focuses in detail on migraine's diverse variations, its pathophysiology, and its treatment. [books.google.com]

Mc Crory PR, Berkovic SF (2001) Concussion: the history of clincal and pathophysiological concepts and miscoceptions. Neurology 57:2283–2289 Google Scholar 3. Miller H (1968) Posttraumatic headache. In: Vinken PJ Bruyn W eds. [link.springer.com]

Posttraumatic retrograde and anterograde amnesia: pathophysiology and implications in grading and safe return to play. J Athl Train. 2001;36:244–8. 16. Maddocks DL, Dicker GD, Saling MM. [aafp.org]

The underlying pathophysiology of concussion appears to be a shearing effect. [dartmouth.edu]

If a tear in these arteries can be diagnosed at the time of the trauma, a patient could be treated with an anti-clotting medicine to help prevent stroke. [sciencedaily.com]

An ideal protective device for prevention of thoracic and abdominal injuries must be secure enough to prevent ejection of the body from the vehicle but slack enough to allow some displacement from the seat during absorption of the impact shock. [britannica.com]

Laser-initiated braking systems can prevent collisions; intelligent seat design can halve the rate of neck injury if an accident occurs. [ 2 ] Prevention of sports injuries, particularly contact sports. Prevention of falls in the elderly. [patient.info]

The following measures may help prevent SCIs: Proper safety practices during work and play can prevent many spinal cord injuries. Use protective equipment for any activity in which an injury is possible. [medlineplus.gov]

The complete management of patients with head and neck trauma, from the accident scene through to rehabilitation Safe, practical tips to assist the non-neurosurgeon in managing head injuries and preventing secondary brain injury—a major concern for emergency [books.google.com]

1. Maroon JC, Bost JW, Petraglia AL, et al. Outcomes Following Anterior Cervical Discectomy and Fusion in Professional Athletes. Neurosurgery. 2013;73(1):103-112.
2. Babu A, Garg H, Sagar S, Gupta A, Kumar S. Penetrating neck injury: Collaterals for another life after ligation of common carotid artery and subclavian artery. Chin J Traumatol. 2017;20 (1):56-58.
3. Lee TS, Ducic Y, Gordin E, Stroman D. Management of carotid artery trauma. Craniomaxillofac Trauma Reconstr. 2014;7(3):175-189.
4. Stassen NA, Hoth JJ, Scott MJ, et al. Laryngotracheal injuries: does injury mechanism matter? Am Surg. 2004;70(6):522-525.
5. Mendis D, Anderson JA. Blunt laryngeal trauma secondary to sporting injuries. J Laryngol Otol. 2017;131(8):728-735.
6. Cheng J, Cooper M, Tracy E. Clinical considerations for blunt laryngotracheal trauma in children. J Pediatr Surg. 2017;52(5):874-880.
7. Asensio JA, Chahwan S, Forno W, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma. 2001;50(2):289-296.
8. Sanchez B, Waxman K, Jones T, Conner S, Chang R, Becerra S. Cervical spine clearance in blunt trauma: Evaluation of a computed tomography-based protocol. J Trauma. 2005;59(1):179–183.
9. Antevil JL, Sise MJ, Sack DI, Kidder B, Hopper A, Brown CV. Spiral computed tomography for the initial evaluation of spine trauma: A new standard of care? J Trauma. 2006;61(2):382–387.
10. Tessler RA, Nguyen H, Newton C, Betts J. Pediatric penetrating neck trauma: Hard signs of injury and selective neck exploration. J Trauma Acute Care Surg. 2017;82(6):989-994.
11. Bodanapally UK, Shanmuganathan K, Dreizin D, et al. Penetrating aerodigestive injuries in the neck: a proposed CT-aided modified selective management algorithm. Eur Radiol. 2016;26(7):2409-2417.