Failure of clinical tests to predict cerebral ischemia before neck manipulation

A case report is presented of a patient with vertebral artery occlusion, demonstrated by digital subtraction angiography, in whom clinical tests designed to test for potential vertebrobasilar insufficiency were negative. The clinical tests used to examine our patient included the vertebrobasilar artery functional maneuver, the Smith and Estridge, Maigne's, Hautand's and Underberge's tests. This case report highlights the limited diagnostic value of these tests.