Pathogenesis of vertebral artery occlusion following cervical spine manipulation

Sporadic cases of vertebral artery occlusion following neck manipulation have been reported since 1947. The pathogenesis of occlusion, however, has remained largely speculative. Autopsy examination of the intracranial and extracranial portions of the vertebral arteries in the case presented here cle...

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Bibliographic Details
Published in:	Archives of pathology & laboratory medicine (1976) Vol. 111; no. 9; p. 851
Main Authors:	Sherman, M R, Smialek, J E, Zane, W E
Format:	Journal Article
Language:	English
Published:	United States 01-09-1987
Subjects:	Adult Brain Ischemia - etiology Brain Stem - blood supply Cervical Vertebrae Chiropractic Headache - therapy Humans Iatrogenic Disease - pathology Manipulation, Orthopedic - adverse effects Vertebral Artery - injuries Vertebral Artery - pathology
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Summary:	Sporadic cases of vertebral artery occlusion following neck manipulation have been reported since 1947. The pathogenesis of occlusion, however, has remained largely speculative. Autopsy examination of the intracranial and extracranial portions of the vertebral arteries in the case presented here clearly demonstrates that intramural hematoma arising within granulation tissue in the tunica media was the acute, occlusive event. Furthermore, prior neck manipulation may have caused asymptomatic development of granulation tissue within the tunica media, thereby predisposing the patient to acute intramural hematoma during subsequent neck manipulation.
ISSN:	0003-9985