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- Title
Vertebral artery dissections after chiropractic neck manipulation in Germany over three years.
- Authors
Reuter, U.; Hämling, M.; Kavuk, I.; Einhäupl, K. M.; Schielke, E.
- Abstract
Vertebral artery dissection (VAD) has been observed in association with chirotherapy of the neck. However, most publications describe only single case reports or a small number of cases. We analyzed data from neurological departments at university hospitals in Germany over a three year period of time of subjects with vertebral artery dissections associated with chiropractic neck manipulation. We conducted a countrywide survey at neurological departments of all medical schools to identify patients with VAD after chirotherapy followed by a standardized questionnaire for each patient. 36 patients (mean age 40 + 11 years) with VAD were identified in 13 neurological departments. Clinical symptoms consistent with VAD started in 55% of patients within 12 hours after neck manipulation. Diagnosis of VAD was established in most cases using digital subtraction angiography (DSA), magnetic resonance angiography (MRA) or duplex sonography. 90% of patients admitted to hospital showed focal neurological deficits and among these 11 % had a reduced level of consciousness. 50% of subjects were discharged after 20 ± 14 hospital days with focal neurological deficits, 1 patient died and 1 was in a persistent vegetative state. Risk factors associated with artery dissections (e. g. fibromuscular dysplasia) were present in only 25% of subjects. In summary, we describe the clinical pattern of 36 patients with vertebral artery dissections and prior chiropractic neck manipulation.
- Subjects
VERTEBRAL artery surgery; MASSAGE; NECK; PHYSICAL therapy; PHYSIOLOGICAL therapeutics
- Publication
Journal of Neurology, 2006, Vol 253, Issue 6, p724
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-006-0099-x