The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature High velocity thrust manipulation of the cervical spine places the carotid and vertebral arteries at risk of dissection. Even with early diagnosis, thrombus occlusion and subsequent infarction can lead to serious adverse outcomes. We report a case of a young woman who had bilateral vertebral artery dissections following chiropractic manipulation. The patient had thrombus occlusion that was not amenable to endovascular treatment and developed hemorrhagic transformation, cerebral edema, and cerebellar herniation. Additionally, ongoing research is necessary to determine the safety of cervical manipulation and whether the techniques should be modified in order to prevent injury.
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