Question
Dear Dr.Leatherman
I was in a rearend collision on 9/07 at rate of 45mph,head was thrown forward and backwards hit head on headrest hard enough to knock me forward a second time,at which time i has severe vibrating pain in my entire head and a sharp pain
shot from base of cervical spine up into base of head on the left side of cervical spine,approx 1 hr after accident I
developed electrical sharp shooting pains up both sides of ant. neck and face with turning of my head,the following morning i was unable to sit up out of bed unassited dur to severe sharp shooting pains that started in bilat ant,chest walls up into neck and face.,but that night I was able to lift arms without same pain,by the following day I had severe pain that radiated from base of skull on right side down to right shoulder ,under right scapule to right ax.Any use of right arm would cause pain to radiate from right clavicle to right shoulder and right upper am.BY day 3 I woke up with the back of right arm and 4th and 5th digit completely numb,by 10/8 I started physical therapy and had no brachial reflexes in right arm and very minimal radial,grip strength in rt hand was 10-12 out of 40 lt hand
20 out of 40,right turning of head was 15 degrees and left
was 25 unable to look upward at all,had MRI on 10/16 it read right paracentral disc
protrusion at C6-C7 resulting in mild effacemnet of spinal cord,neurosergeon stated their was a significant of imflammation around spinal cord as well.On 10/19 I woke with dizzy with blurry vision,right hand grasped closed,had use left hand to open finger,when attempting to write right hand would just tap on paper as if my hand could not follow signal of brain,notice by mid morning that rt leg was going up on tip toe,since this day it has been pretty much down hill I continued with physical therapy,which was helping with ROM and numbness,EXcept for I still could not bend head
laterally to either side without severe electrical type pain and instant dizziness to the point I thought I was going to fall.And weakness of right leg continued over next weeks and months I things appeard to be tilt downward to right,vision became blurrier,words appeared to dancing on the page,when sitting I could feel my neck with the constant
back and forth movement,gait gait became very wide and waddling,eventually ended up in vestibualr therapy to help with dizziness and gait.vestibualr seem to make dizziness worse I think due to the constant side to side and up and down movement of neck.I would be more dizzy after therapy and have difficult concentrating and difficulty with speech,put it this way their was such a noticable difference mentally that my co-workers knew when I had been to therapy even I did not tell them.In last few weeks I have devloped constant buring with pins and needles feeling in bilat hands and forearms and use of right arm cause intensitiy if pins and needles to increase,when flexing head downward to read I angetting the numbess and prickly feeling up back of neck and scalp and to bilat lower face and tongue.With too much use of right as typing too much at work,I get this severe sharp,riping pain at approx 2nd intercoastal space that radiates up to right shoulder,right side of neck to back of right side of head and down right arm,neck becmes very stiff and remain very stiff for a few days,vision becames blurry and I have the vision blurriness and severe light sensivity has long as neck is stiff(stiff as in I can not turn it to the right at all without feeling like everything is going black and I am going to pass out.Neurosurgeon,ssaid surgery would noy help because I had
symtoms on right and left(I think I may have left out by Nov
the pains were shooting from lt side of neck to lt scapula)
Vestibular therapist did veterbal artery insuffiency testing on me and I was positive bilaterl with ataxia(bot that is something I never will do again,although it produced the same feeling and symtoms I had when I woke up dizzy that first time and remained that way for approx a week and half.I had cerebral angiogram and vessel looked okay.Is their anything you can recommend or where to pin to point my problem.I an tired of not being able to do anyhting without the after effects of pain, increased numbess,blurry vision, severe occipital headaches and dizziness.Right leg still has stepping action or if I tried to walk fast it swings out to the side,If I am turning a right corner I have to go wide because right foot will not turn right.I will come to you if you can help.
please help Melissa

Answer
Dear Melissa,

Ouch...Sorry to hear of the problems.  Although your symptoms should be considered extensive, these symptoms are a common manifestation of rear-impact vectored collisions.  These issues are all caused due to the accelerational forced being transmitted through the spine in an almost instantaneous time frame...before you can actually create a muscular response for stabilization.  It is a transfer of the kinetic energy from the striking vehicle into your body.  This often results in torn ligaments, herniated disks, torn musculature, head and neck pain, pain down the arms, and upper back pain, but also dizziness, impaired cognition, vertigo, ringing in the ears, loss of reflexes, loss of strength, avulsion fractures in the vertebral endplates, nerve damage, cord damage, etc...  

With what you have described, I would also opine that you are experiencing not only neurological pain but also sclerotogenous(referred pain) and myofascial pain.  Moreover, you most likely have what is called a diffuse axonal injury to your brain tissue as well, which is hard to document other than with clinical and cognitive assessment...imaging tests such as CT and MRI do not pick this up readily, but biopsy studies have proven it to occur.

The best immediate advice I can give you is to try and find a good chiropractic physician to aid in your care program.  In my opinion, you must find one who is educated in whiplash trauma and mild traumatic brain injury for the best effective care.  I would direct you to the Spine Research Institute of San Diego, www.srisd.com, for the best information on injury and treatment options.  They also have a physician referral, so you can find certified doctors in your state.

I would further suggest that you send me a personal e-mail through my website, so that I can send you better documentation and explanations on the injury, what to do, and how to manage care.  I have a lot of information I can give you, but it is too extensive to be done through the allexpert site.  I would be happy to send it to you via e-mail.

Respectfully,
Dr. J. Shawn leatherman
www.suncoasthealthcare.net