1/2. Acute peripheral vestibular deficits after whiplash injuries.We report 3 patients who had acute peripheral vestibular dysfunction minutes to hours after a car collision with whiplash injury without head trauma. The accident was a frontal collision in 1 case, a rear impact in the second, and lateral in the third. All patients complained immediately of cervicalgia, headache, acute vertigo with a sensation of erroneous body movements, and slipping of image with head movements. A sudden sensation of tilting of the environment when driving, tinnitus, and hyperacusis were also described. The otoneurologic findings showed bilateral canalolithiasis in 1 patient and an acute peripheral vestibular deficit in 2 patients. Tilt of the subjective visual vertical was measured in all patients. Cerebral magnetic resonance imaging yielded normal findings. As angular and linear accelerometers, the vestibular organs are directly exposed to high forces generated by whiplash mechanisms. vertigo generated by peripheral vestibular lesions is probably underestimated in whiplash injuries and may often be incorrectly attributed to cervical or cerebral lesions.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/2. Transient short free running circadian rhythm in a case of aneurysm near the suprachiasmatic nuclei.A free running circadian rest-activity cycle is rare in sighted individuals living in a normal environment. Even more rare is a periodicity shorter than 24 hours, as observed in actigraphic recordings in a female patient during convalescence after a whiplash injury in a car accident. The documented free running period was 22.5 hours for 19 days. During the subsequent weeks re-entrainment occurred following re-establishment by a social zeitgeber, with a slightly early circadian phase of nocturnal melatonin onset relative to a late sleep period. magnetic resonance imaging and cerebral angiography showed an aneurysm at the bifurcation of the right internal carotid artery, close to the circadian pacemaker structure (the suprachiasmatic nuclei), which was later occluded.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |