Prospects and Prediction of Post-Traumatic Headache after Whiplash Injury

Approximately 90 % of patients complain about head or neck pain following whiplash injury. These complaints most often resolve within the first few weeks after the accident. However, about 10 - 20 % of the patients develop chronic post-traumatic headache. Can we identify any psychological factors that may contribute to the development of this chronic pain state, or recognise factors that might prevent chronification? To answer these questions, we have conducted a multicentre, prospective study with 21 participating accident and emergency departments. We used different, validated neuropsychological tests: Neck Disability Index (NDI); Kiel Pain Inventory (KSI); Questionaire of pain coping strategy acquisition (FESV); Freiburg Personality Inventory (FPI); Hospital Anxiety and Depression Scale - German Version (HADS-D); and an individual headache diary. Preliminary results point out several possible psychological features that may favour the development of chronic post-traumatic headache following whiplash injury. Whether these changes are solely due to psychological alterations or whether additional underlying structural cerebral changes may also play a considerable role is being investigated in additional MRI examinations.