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Provision of highly specialised services

pain is of no value in localising the site of the lesion.2 We advocate consultation with a senior doctor and consideration of early computed tomography for patients with a good history of neck rotation at the time of impact. This increases the chance of bony injury,2 particularly between the occiput and C2, which is often poorly visualised in plain films. Computed tomography should also be considered in those with a fixed abnormal neck position, particularly if pain does not seem to be the restricting factor, and those with definite neurological signs and symptoms, even if their presentation is delayed.