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Vertebral artery dissection and cerebellar infarction following chiropractic manipulation
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  1. W-L Chen1,
  2. C-H Chern2,
  3. Y-L Wu3,
  4. C-H Lee4
  1. 1Department of Emergency Medicine, Cathay General Hospital, and Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
  2. 2Department of Emergency Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China
  3. 3Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan, Republic of China
  4. 4Institute of Emergency and Critical Care Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China
  1. Correspondence to:
 Dr W-L Chen
 Department of Emergency Medicine, Cathay General Hospital, 280 Jen-Ai Road, Section 4, Taipei 106, Taiwan, Republic of China; weilung.chen{at}msa.hinet.net

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.

  • ED, emergency department
  • VAD, vertebral artery dissection
  • VBI, vertebrobasillar
  • vertebral artery dissection
  • manipulation

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Footnotes

  • Competing interests: none declared

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