Association of Internal Carotid Artery Dissection and Chiropractic Manipulation

Haneline, Michael T.; Croft, Arthur C.; Frishberg, Benjamin

doi:10.1097/01.nrl.0000038583.58012.10

Cited by 46 publications

(31 citation statements)

References 66 publications

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“…1 The ICA can also abut bony structures with movements of the neck; this is likely a result of stretch or compression against the processes of the upper cervical vertebrae or against the petrous bone as the ICA enters the skull base. 63,156,159 In general, ICAD has been thought to occur more frequently than VAD, but there clearly is variability, depending on the population studied. Most series have combined spontaneous and provoked/traumatic dissections.…”

Section: Location Of Arterial Dissections and Cmtmentioning

confidence: 99%

“…66,88,148 The ICA may potentially be injured during cervical manipulation. [155][156][157] With extension and lateral flexion of the head, the artery becomes fixed in place, abutting the upper cervical vertebrae. 156 …”

Section: Postulated Mechanisms Of Vessel Injurymentioning

confidence: 99%

“…[155][156][157] With extension and lateral flexion of the head, the artery becomes fixed in place, abutting the upper cervical vertebrae. 156 …”

Section: Postulated Mechanisms Of Vessel Injurymentioning

confidence: 99%

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Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

179

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3155Purpose-Cervical artery dissections (CDs) are among the most common causes of stroke in young and middle-aged adults.The aim of this scientific statement is to review the current state of evidence on the diagnosis and management of CDs and their statistical association with cervical manipulative therapy (CMT). In some forms of CMT, a high or low amplitude thrust is applied to the cervical spine by a healthcare professional. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council's Scientific Statements Oversight Committee and the American Heart Association's Manuscript Oversight Committee. Members were assigned topics relevant to their areas of expertise and reviewed appropriate literature, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge. Results-Patients with CD may present with unilateral headaches, posterior cervical pain, or cerebral or retinal ischemia (transient ischemic or strokes) attributable mainly to artery-artery embolism, CD cranial nerve palsies, oculosympathetic palsy, or pulsatile tinnitus. Diagnosis of CD depends on a thorough history, physical examination, and targeted ancillary investigations. Although the role of trivial trauma is debatable, mechanical forces can lead to intimal injuries of the vertebral arteries and internal carotid arteries and result in CD. Disability levels vary among CD patients with many having good outcomes, but serious neurological sequelae can occur. No evidence-based guidelines are currently available to endorse best management strategies for CDs. Antiplatelet and anticoagulant treatments are both used for prevention of local thrombus and secondary embolism. Case-control and other articles have suggested an epidemiologic association between CD, particularly vertebral artery dissection, and CMT. It is unclear whether this is due to lack of recognition of preexisting CD in these patients or due to trauma caused by CMT. Ultrasonography, computed tomographic angiography, and magnetic resonance imaging with magnetic resonance angiography are useful in the diagnosis of CD. Follow-up neuroimaging is preferentially done with noninvasive modalities, but we suggest that no single test should be seen as the gold standard.

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Section: Location Of Arterial Dissections and Cmtmentioning

confidence: 99%

Section: Postulated Mechanisms Of Vessel Injurymentioning

confidence: 99%

See 1 more Smart Citation

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Biller¹,

Sacco²,

Albuquerque³

et al. 2014

Stroke

179

View full text Add to dashboard Cite

show abstract

“…Internal Carotid and Vertebral Arterial Dissection (ICAD and VAD respectively) with subsequent stroke are known risk factors for patients experiencing traumatic injury to the head or neck [Haneline MT et al 2003, Cassidy JD et al 2008, Wynd S et al 2013. Moreover, there is at least a temporal correlation between ICAD and chiropractic neck manipulations, although a clear causative link has and continues to be strongly argued against or at least questioned [Biffl WL et al 1998, Norris JW et al 2000, DeSouza RM et al 2011.…”

Section: Risk Of Carotid Dissectionmentioning

confidence: 99%

“…Moreover, there is at least a temporal correlation between ICAD and chiropractic neck manipulations, although a clear causative link has and continues to be strongly argued against or at least questioned [Biffl WL et al 1998, Norris JW et al 2000, DeSouza RM et al 2011. Identified risk factors for Cervical Arterial Dissection (CAD) have been reported as abrupt hyper neck; flexion, extension, and particularly rotation -or more generally "sudden head movement" -all of which imply a history of sudden and forceful stretching, twisting or tortion of the dissected vessel [Haneline MT et al 2003, Cassidy JD et al 2008, Wynd S et al 2013.…”

Section: Risk Of Carotid Dissectionmentioning

confidence: 99%

Carotid Vibro-Compression: A Reperfusive Treatment for Acute Ischemic Stroke? Feasibility Data and a Potential Risk / Benefit Discussion in View to Animal Testing

Hoffmann¹,

Gill²

2017

J Exp Stroke Transl Med

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Slow uncertain reperfusion in Acute Ischemic Stroke (AIS) by intravenous thrombolysis has prompted search for alternative therapies. Pressure/flow disturbances from rapid compressions (20 -24 Hz) of a clotted flow tube remote from thrombosis site have shown to assist reflow. Carotid Vibro-Compression (VC), a potentially risky maneuver, may therefore enhance AIS reperfusion but verification is needed that vibro-compressions would transmit flow disturbances to the cerebral arteries. From a pool of 15 volunteers (mean age 48) carotid compressions (5 to 8 Hz, < = ~1 cm) (n =11) and vibration (30 Hz ~ 1 mm) (n = 10) were independently and together implemented with ipsilateral and contralateral Doppler flow monitoring of an intra-cranial artery. Doppler pulses from compressions were immediately demonstrated in all vessels (26 / 26) under all conditions. Pulses from vibration were observable in a majority of vessels (22 / 25), but signals were often challenging to obtain. Mean intra-cranial flow velocities trended to increase during compressions (46.1 ± 6 .4 cm/s vs. 44.0 ± 4.9 cm/s), but the difference was not statistically significant (p = 0.06). Carotid VC reliably transmits flow pulses to the cerebral vasculature, however vibration requires biofeedback to ensure device positioning. Carotid VC appears feasible for animal testing, but safety remains a major question.

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Cracking the Problem of Back Pain

Ness¹,

Nisly²

2004

Arch Intern Med

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Association of Internal Carotid Artery Dissection and Chiropractic Manipulation

Abstract: The medical literature does not support a clear causal relationship between CMT and ICAD. Reported cases are exceedingly scarce, and none support clear cause and effect.

Cited by 46 publications

References 66 publications

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

Carotid Vibro-Compression: A Reperfusive Treatment for Acute Ischemic Stroke? Feasibility Data and a Potential Risk / Benefit Discussion in View to Animal Testing

Cracking the Problem of Back Pain

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