5.3 Acute headache attributed to whiplash[^1]

Identification: 32-year-old female patient, previously healthy, with no history of chronic headache or other significant comorbidities. History of Present Illness: The patient was involved in a motor vehicle accident 5 days ago, in which the vehicle she was in was rear-ended, causing a sudden acceleration-deceleration movement of the head ("whiplash" mechanism). At the time of the accident, the patient did not lose consciousness but immediately complained of neck pain and muscle stiffness. Over the past 48 hours, she developed an intense, pulsatile headache located in the occipital region, radiating to the temporal areas. The pain worsens with head movements and is accompanied by mild dizziness and nausea, without vomiting. She also reports difficulty concentrating and sensitivity to light. Physical Examination: Neurological: Pupils are isocoric and photoreactive, with no motor or sensory deficits. Deep tendon reflexes are normal and symmetrical. Cervical Spine: Tenderness on palpation of the posterior cervical region, with limited range of motion in rotation and flexion/extension. Other: No signs of external cranial trauma or other visible injuries. Complementary Examinations: Cranial Computed Tomography (CT): No acute changes such as hemorrhages or fractures. Cervical Spine Magnetic Resonance Imaging (MRI): Mild edema in the paravertebral soft tissues, with no evidence of spinal cord injury or fractures. Transcranial Doppler: Cerebral blood flow within normal parameters.