Post-manipulative stroke: a study of two cases

Abstract

Spinal manipulative therapy to the cervical, and especially the upper cervical, spinehas been linked to stroke of the posterior circulation affecting the cerebellum and brain stem.

Two cases are presented in which chiropractors manipulated patients who presented with neck pain and headaches, resulting in post-manipulative stroke in both cases. Analysis of the cases and review of the relevant literature demonstrate that these scenarios remain both extremely rare and unpredictable. Appropriate post-indicent management is a key factor in the patient's prognosis.