[Bilateral vertebral artery dissection after chiropractic treatment]

Area of Science:

• Neurology
• Vascular Medicine
• Physical Therapy

Background:

• Cervical manipulation is a common treatment for neck pain.
• Vertebral artery dissection is a rare but serious complication.
• Brainstem infarction can result from compromised blood flow to the brainstem.

Observation:

• A 31-year-old woman experienced a brainstem infarction.
• The infarction occurred after chiropractic neck manipulation.
• Magnetic resonance (MR) tomography revealed dissection in both vertebral arteries.

Findings:

• The patient's brainstem infarction was directly linked to vertebral artery dissection.
• The dissection was a consequence of the chiropractic neck manipulation.
• This case highlights a severe adverse event associated with spinal manipulation.

Implications:

• Clinicians, especially physical therapists, must be aware of potential vertebrobasilar complications after spinal manipulation.
• Early recognition and diagnosis of vertebral artery dissection are crucial for patient outcomes.
• Risk-benefit assessment is essential when considering cervical manipulation therapies.