Medico-legal assessment of so-called whiplash injury

Most rear-end collisions are of minor severity. In the past, the biomechanical events and the possible medical sequelae of these accidents were subject to speculation. Recently, investigations in several laboratories with the help of high-speed cameras and of electronic recording devices have demonstrated that the duration of the crash-phase is only about 3/10 s and that the alledged whiplash mechanism does, in fact, not occur. The co-called Late Whipash Syndrome is not characteristic for rear-end or other automobile collisions. The same set of symptoms is observed in various conditions of highly debatable nosological status. The patient's complaints appear to be associated with depression. The problems of cervical vertigo, of neuro-otological studies, of osteopathic findings, the role of SPECT and of MRT of the atlanto-axial joints and alar ligaments in the study of these cases are discussed. There exists a framework of rules on a national as well as international basis for the medico-legal assessment of these patients.