Vertebral artery dissection and cerebellar infarction following chiropractic manipulation. Issue 1 (22nd December 2005)

• Record Type: Journal Article
• Authors: Chen, W-L; Chern, C-H; Wu, Y-L; Lee, C-H
• Is Part Of: Emergency medicine journal. Volume 23:Issue 1(2006)
• Page Start: e01
• Page End: e01
• Publication Date: 2005-12-22
• Subjects: ED, emergency department -- VAD, vertebral artery dissection -- VBI, vertebrobasillar; vertebral artery dissection -- manipulation; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1136/emj.2004.015636
• Languages: English
• ISSNs: 1472-0205

Abstract

Abstract : Vertebral artery dissection (VAD) associated with chiropractic cervical manipulation is a rare but potentially disabling condition. In this report, we present a young patient manifesting with repeated vertigo. Owing to the initial misdiagnosis, the patient later developed cerebellar stroke with inability to stand or walk. Vertigo and disequilibrium are the usual presenting symptoms of this condition, which can result from inner ear or vestibular nerve dysfunction, vertebrobasilar insufficiency, and even lethal cerebellar infarction or haemorrhage; these last two, although rarely seen in young adults, can be caused by traumatic or spontaneous arterial injury, including injury secondary to chiropractic cervical manipulation. A number of cases of VAD associated with chiropractic cervical manipulation have been reported, but rarely in the emergency medicine literature. We present a case of this rare occurrence, and discuss the diagnostic pitfalls.