Traumatic vertebrobasilar occlusive disease in childhood

Vigorous gymnastics and repeated manipulations of the cervical spine by a chiropractor were associated with headaches and transient cranial nerve deficits in a 7-year-old boy who had a history of birth trauma. Progressive cerebellar dysfunction was later accompanied by a visual field defect. A computerized axial tomography scan revealed a cerebellar infarction, and arteriograms showed vertebral and basilar occlusions. Passive stretching of the cervical spine during chiropractic maneuvers may lead to vertebral artery thrombosis with subsequent embolization into the basilar artery circulation.