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Vertebral artery dissection complicated by cervical manipulation: a case report

J L Wang1, J J Lin, J C Lin

  • 1Department of Family Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|June 1, 1995
PubMed
Summary

Cervical manipulation can lead to vertebro-basilar dissection, causing stroke. Early awareness and prevention are crucial to avoid progressive infarction after this procedure.

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Area of Science:

  • Neurology
  • Vascular Surgery

Background:

  • Cervical manipulation is a common procedure.
  • Vertebro-basilar dissection is a rare but serious complication.

Observation:

  • A healthy 32-year-old man experienced neurological symptoms including vomiting, blurred vision, and altered consciousness after cervical manipulation.
  • Physical examination revealed stuporous consciousness and horizontal nystagmus.
  • Brain imaging (CT and MR) showed infarction in the basilar artery territory.

Findings:

  • MR angiography and vertebral angiography confirmed dissection of the right vertebral artery at the atlantoaxial segment.
  • The patient was treated with antiedematous drugs and showed gradual improvement.
  • Six months post-event, mild cerebellar ataxia was noted.

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Implications:

  • This case highlights the potential risk of vertebro-basilar dissection following cervical manipulation.
  • Physicians and patients should be aware of this association.
  • Preventive strategies are needed to mitigate the risk of progressive infarction.