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Wallenberg's syndrome following neck manipulation.

L R Frumkin1, R W Baloh

  • 1Department of Neurology, University of California, Los Angeles 90024.

Neurology
|April 1, 1990
PubMed
Summary

Chiropractic neck manipulation can cause lateral medullary infarction (Wallenberg's syndrome), even in young, healthy individuals. This study details four cases, highlighting vertebral artery dissection as a potential complication.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Chiropractic Medicine

Background:

  • Lateral medullary infarction, also known as Wallenberg's syndrome, is a type of stroke.
  • Chiropractic neck manipulation has been anecdotally linked to vertebral artery dissection and subsequent stroke.

Observation:

  • Four patients aged 28-41 developed lateral medullary infarction after chiropractic neck manipulation.
  • Angiography revealed extracranial vertebral artery dissection in three of the four patients.
  • Neurologic symptoms appeared within four days of the manipulation.

Findings:

  • The study highlights that vertebral artery dissection and stroke can occur following chiropractic neck manipulation.
  • Lateral medullary infarction was observed in young, healthy individuals without typical predisposing risk factors for stroke.

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  • All patients experienced good recovery with minimal residual neurological deficits.

    • Implications:

    • This case series suggests a need for increased awareness among healthcare providers and the public regarding the potential risks of chiropractic neck manipulation.
    • Further research may be warranted to understand the mechanisms and incidence of this association.
    • Patients considering chiropractic neck manipulation should be informed about the potential, albeit rare, risk of cerebrovascular events.