A Case of Posterior Inferior Cerebellar Artery Infarction after Cervical Chiropractic Manipulation

Jeong, Do Kyeun; Hwang, Sung-Kyun

doi:10.13004/kjnt.2018.14.2.159

Cited by 7 publications

(10 citation statements)

References 10 publications

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“…Although patients with PICA dissection tended to hemorrhage compared with ischemia 94 , Junpei et al still found that isolated PICA dissection caused 6% of the PICA region infarcts by reviewing 167 cases, equal to VA dissection, which hinted the undervalued clinical importance of PICA dissection 95 . Jeong et al reported a rare case of PICA infarct after cervical chiropractic manipulation 96 . Extradural origin of PICA could be injured accidently by the cervical surgery 97 .…”

Section: Ischemic Strokementioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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The posterior inferior cerebellar artery (PICA), with its unique anatomical complexity, is of great clinical importance and involved in many diseases including aneurysm, ischemic stroke, neurovascular compression syndrome (NVCS), arteriovenous malformation (AVM), and brain tumor. However, a comprehensive systematic review of the importance of the PICA is currently lacking. In this study, we perform a literature review of PICA by searching all the associated papers in the PUBMED database hoping to provide a better understanding of the artery. The PICA has tortuous and variable course and territory, divided into 5 segments. Various aneurysms involving PICA were not uncommon, of which the treatment is challenging. The PICA infarct typically manifests lateral medullary syndrome (LMS) and is more likely to cause mass effects. The PICA frequently compresses the medulla and the cranial nerves resulting in various neurovascular compression syndromes (NVCS). Arteriovenous malformation (AVM) fed by PICA are associated with aneurysm and dissection which have high risk of rupture and worse outcome. PICA injured by head trauma can cause fatal SAH. VA terminating in PICA probably cause Bow hunter's syndrome (BHS). The PICA supplies many brain tumors and can be used in intracerebellar chemotherapy. The PICA can be exposed and injured during surgeries especially in telovelar approach, and it also plays an important role in bypass surgeries, hinting the surgical importance of PICA. In conclusion, PICA is very important in clinical practice.

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Section: Ischemic Strokementioning

confidence: 99%

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Miao¹,

Zhang²,

Wang³

et al. 2020

Int. J. Med. Sci.

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“…These do not appear to be minor adverse effects, even if they did resolve by 24 hours. But Gergen and Jeong [ 21 , 22 ] reported infarction of the posterior inferior cerebellar artery and mild traumatic brain injury (mTBI) which occurred likely because of shedding of the thrombus after manual therapy. Therefore, it is essential for the physical therapist to evaluate the risks before initiating treatment.…”

Section: Evidence Synthesismentioning

confidence: 99%

The efficiency and safety of manual therapy for cervicogenic cephalic syndrome (CCS)

Jin¹,

Du²,

Qiao³

et al. 2021

Medicine

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Background: Manual therapy is a common technique for the treatment of (CCS) cervicogenic cephalic syndrome, but the efficiency is various. The aim of the study is to evaluate the evidence pertaining to the efficiency and safety of using manual therapy to treat patients with CCS. Methods: We searched the electronic databases including PubMed, ScienceDirect, and the Cochrane Library. Only randomized controlled trials (RCTs) were enrolled in this systematic review and cumulative meta-analysis. Results: A total of 8 RCTs with 395 patients were included for meta-analysis. Patients who underwent manual therapy showed lower scores of visual analog scale (VAS) (weighted mean difference) WMD = 1.7, 95% confidence interval CI = 0.74–2.65, P = .0005); dizziness handicap inventory (DHI) (WMD = 0.66, 95%CI = 0.31–1, P = .0002); and neck disability index (NDI) (WMD = 0.59, 95%CI = 0.23–0.96, P = .002) and better rotation range of motion (ROM) of the cervical spine (WMD = −6.54, 95%CI = −7.60 to −5.48, P < .0001). However, these patients did not show much benefit from manual therapy with respect to the frequency of CCS episodes and head repositioning accuracy (HRA). No serious adverse effects were reported in our included studies lasting longer than 24 hours. Conclusions: Manual therapy offers an effective and safe approach to treat CCS with lower VAS, DHI, and NDI scores and better cervical spinal movement. Further high-quality RCTs are required to provide more conclusive evidence. Systematic review registration number: PROSPERO172740.

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“…In the literature, several cases of infarction have been reported after chiropractic therapy and, to a lesser extent, after self-cervical manipulation. And all of these cases are associated with vascular pathologies [5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report

Ademoğlu

İslam

Aksel

et al. 2020

Journal of Emergency Medicine Case Reports

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Introduction: Spinal manipulation is a widely used method in the treatment of neck pain, but it has the potential for serious complications. Although controversial, stroke can occur especially after cervical manipulation. Stroke secondary to self-cervical manipulation is rare and only a few cases have been reported. Case Report:We reported a 28-year-old male patient with complaints of dizziness, neck pain and right hemiparesthesia. Except the cerebellar gait and right hemiparesthesia, his neurological examination was normal. It was learnt that his complaints started an hour after the self-cervical manipulation. His brain computed tomography, brain and cervical computed tomography angiography were normal limits. The brain diffusion magnetic resonance imaging (MRI) revealed an acute infarction area. He was discharged without sequelae with antiaggregant treatment, after 8 days of follow-up in the hospital. Conclusion:Although it is controversial whether the risk of stroke increases after cervical manipulation, we believe the risk of stroke may increase, especially when the manipulation is performed by non-professionals. Especially in younger patients with a history of cervical manipulation and neurological complaints, stroke should be suspected even if the neurological examination is normal.

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A Case of Posterior Inferior Cerebellar Artery Infarction after Cervical Chiropractic Manipulation

Cited by 7 publications

References 10 publications

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

Clinical Importance of the Posterior Inferior Cerebellar Artery: A Review of the Literature

The efficiency and safety of manual therapy for cervicogenic cephalic syndrome (CCS)

An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report

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