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Related Experiment Videos

Thalamic infarction secondary to cervical manipulation

M Sinel1, D Smith

  • 1Department of Physical Medicine and Rehabilitation, Veterans Administration Medical Center, West Los Angeles, CA.

Archives of Physical Medicine and Rehabilitation
|May 1, 1993
PubMed
Summary

Cervical manipulation can cause vertebrobasilar infarction, including rare thalamic infarcts. This case highlights the risks of forceful neck manipulation, leading to posterior circulation stroke.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Cerebrovascular Disease

Background:

  • Cervical manipulation is a known risk factor for vertebrobasilar infarction.
  • The typical pathogenesis involves vertebral artery intimal tear causing posterior fossa lesions.
  • Thalamic infarcts have not been previously reported in this context.

Observation:

  • A patient developed thalamic, brainstem, and cerebellar infarction after cervical manipulation.
  • The infarction was associated with intimal tearing of the vertebral artery.
  • Neurological deficits included nystagmus, quadriparesis, and speech impairment.

Findings:

  • This case presents the first reported instance of thalamic infarction secondary to cervical manipulation.
  • The findings support the link between vertebral artery intimal tears and extensive posterior circulation stroke.

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  • The patient showed partial recovery with persistent speech and perceptual deficits after rehabilitation.

    • Implications:

    • This case underscores the potential neurological risks associated with forceful cervical manipulation.
    • It emphasizes the need for careful consideration of patient history and potential complications.
    • Further research may be warranted to fully understand the mechanisms and incidence of such events.