Vertebral Artery Injuries Following Chiropractic Cervical Spine Manipulation —Case Reports

Raskind, R; North, Charles M.

doi:10.1177/000331979004100605

Cited by 31 publications

(6 citation statements)

References 4 publications

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“…The majority of papers on this topic extrapolate conclusions from single case reports or small series of two to five cases. In only two cases [19,25] do the authors report any attempt to isolate the type of manipulation that precipitated the cerebrovascular insult or to determine the number of manipulations that the patient received prior to the incident by contacting the practitioner of manipulation. The inability to access the records of the practitioner who provided the cervical manipulation therapy has also resulted in very little information on the presenting symptoms of patients that develop symptoms of cerebrovascular ischemia following manual manipulation.…”

mentioning

confidence: 99%

Stroke, cerebral artery dissection, and cervical spine manipulation therapy

Haldeman¹,

Kohlbeck

McGregor³

2002

Journal of Neurology

103

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Stroke represents an infrequent adverse reaction associated with cervical spine manipulation therapy. Attempts to identify the patient at risk and the type of manipulation most likely to result in these complications of manipulation have not been successful. A retrospective review of 64 medical legal cases of stroke temporally associated with cervical spine manipulation was performed to evaluate characteristics of the treatment rendered and the presenting complaints in patients reporting these complications. These files included records from the practitioner who administered the manipulation therapy, post stroke testing and treatment records usually by a neurologist, and depositions of the patient and the practitioner of manipulation as well as expert and treating physicians. A retrospective review of the files was carried out by three (two in 11 cases) researchers using the same data abstraction instrument to independently assess each case. These independent reviews were followed by a consensus review in which all reviewers reached agreement on file content. Ninety two percent of cases presented with a history of head and/or neck pain and 16 (25 %) cases presented with sudden onset of new and unusual headache and neck pain often associated with other neurological symptoms that may represent a dissection in progress. The strokes occurred at any point during the course of treatment. Certain patients reporting onset of symptoms immediately after first treatment while in others the dissection occurred after multiple manipulations. There was no apparent dose-response relationship to these complications. These strokes were noted following any form of standard cervical manipulation technique including rotation, extension, lateral flexion and non-force and neutral position manipulations. The results of this study suggest that stroke, particularly vertebrobasilar dissection, should be considered a random and unpredictable complication of any neck movement including cervical manipulation. They may occur at any point in the course of treatment with virtually any method of cervical manipulation. The sudden onset of acute and unusual neck and/or head pain may represent a dissection in progress and be the reason a patient seeks manipulative therapy that then serves as the final insult to the vessel leading to ischemia.

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confidence: 99%

Stroke, cerebral artery dissection, and cervical spine manipulation therapy

Haldeman¹,

Kohlbeck

McGregor³

2002

Journal of Neurology

103

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“…In den letzten Jahren erschienen in der Literatur immer wieder Fallberichte über Dissektionen der groûen Halsarterien nach chiropraktischer Behandlung [12,22]. Grayson (1987), Heine et al (1998) und Parwar et al (2001) beschrieben ebenfalls solche Fälle, die nach chiropraktischer Manipulation der Halswirbelsäule durch ein Horner-Syndrom auffällig wurden.…”

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Horner-Syndrom bei Karotisdissektion nach chiropraktischer Manipulation

Gamer¹,

Schuster²,

Aicher³

et al. 2002

Klin Monatsbl Augenheilkd

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“…Traumatic VAD is common with major penetrating or blunt neck trauma, including knife, shrapnel, and gunshot wounds and motor vehicle accidents [9,14,39]. In addition, VAD is frequently precipitated by minor neck injury, including chiropractic manipulations, yoga exercises, or simple neck movements [4,11,26]. In conscious patients, VAD may provoke symptoms related to lateral medulla oblongata ischemia, such as suboccipital or supraorbital headache, vertigo, and vomiting [35].…”

Section: Introductionmentioning

confidence: 99%

Unilateral and bilateral vertebral artery dissection following motor vehicle injury—Two cases and a mini-review

Mandila¹,

Koukoulitsios²,

Stathopoulos³

et al. 2011

Int J Angiol

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Vertebral artery dissection in two patients with traumatic brain and cervical spine injury was treated in the intensive care unit. In both cases vertebral artery dissection was suspected solely by the presence of ischemic lesions on the cervical spine and by magnetic resonance imaging of the brain, performed because of a failure to recover consciousness. In the intensive care unit patients with head and neck trauma, symptoms of posterior circulation ischemia due to traumatic vertebral artery dissection, often overlap with those with traumatic brain injury. A high level of suspicion for vertebral artery dissection has to be maintained in order to prompt further investigation in to these cases.

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Vertebral Artery Injuries Following Chiropractic Cervical Spine Manipulation —Case Reports

Cited by 31 publications

References 4 publications

Stroke, cerebral artery dissection, and cervical spine manipulation therapy

Stroke, cerebral artery dissection, and cervical spine manipulation therapy

Horner-Syndrom bei Karotisdissektion nach chiropraktischer Manipulation

Unilateral and bilateral vertebral artery dissection following motor vehicle injury—Two cases and a mini-review

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