Case Report
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An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report

Year 2020, Volume: 11 Issue: 4, 98 - 100, 28.12.2020
https://doi.org/10.33706/jemcr.789735

Abstract

İntroduction
Spinal manipulation is a widely used method in the treatment of neck pain, but it has the potential for serious complications. Although controversial, stroke can occur especially after cervical manipulation. Stroke secondary to self-cervical manipulation is rare and only a few cases have been reported.
Case Report
We reported a 28-year-old male patient with complaints of dizziness, neck pain and right hemiparesthesia. Except the cerebellar gait and right hemiparesthesia, his neurological examination was normal. It was learnt that his complaints started an hour after the self-cervical manipulation. His brain computed tomography, brain and cervical computed tomography angiography were normal limits. The brain diffusion magnetic resonance imaging (MRI) revealed an acute infarction area. He was discharged without sequelae with antiaggregant treatment, after 8 days of follow-up in the hospital.
Conclusion
Although it is controversial whether the risk of stroke increases after cervical manipulation, we believe the risk of stroke may increase, especially when the manipulation is performed by non-professionals. Especially in younger patients with a history of cervical manipulation and neurological complaints, stroke should be suspected even if the neurological examination is normal.

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Project Number

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Thanks

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References

  • [1] Rothwell DM, Bondy SJ, Williams JI. Chiropractic manipulation and stroke: a population- based case-control study. Stroke. 2001 May;32(5):1054-60. doi: 10.1161/01.str.32.5.1054.
  • [2] Haldeman S, Kohlbeck FJ, McGregor M. Stroke, cerebral artery dissection, and cervical spine manipulation therapy. J Neurol. 2002 Aug;249(8):1098-104. doi: 10.1007/s00415-002-0783-4.
  • [3] Albuquerque FC, Hu YC, Dashti SR, Abla AA, Clark JC, Alkire B, et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management. J Neurosurg. 2011 Dec;115(6):1197-1205. doi: 10.3171/2011.8.JNS111212.
  • [4] Mukherjee ST. Cervical Manipulation Leading to Cerebellar Stroke in a Pilot. Aerosp Med Hum Perform. 2015 Dec;86(12):1066-9. doi: 10.3357/AMHP.4400.2015.
  • [5] Kowlgi NG, Gowani SA, Mota P, Haider J. Self-inflicted vertebral artery dissection: a case report and review of literature. Conn Med. 2013 Oct;77(9):551-2. PMID: 24266133
  • [6] Jeret JS, Bluth M. Stroke following chiropractic manipulation. Report of 3 cases and review of the literature. Cerebrovasc Dis. 2002;13(3):210-3. doi: 10.1159/000047778
  • [7] Jeong DK, Hwang SK. A Case of Posterior Inferior Cerebellar Artery Infarction after Cervical Chiropractic Manipulation. Korean J Neurotrauma. 2018 Oct;14(2):159-163. doi: 10.13004/kjnt.2018.14.2.159.
  • [8] Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, et al. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap. 2017 Nov 22;25:35. doi: 10.1186/s12998-017-0165-8.
  • [9] Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: an overview of reviews. Syst Rev. 2017 Mar 24;6(1):64. doi: 10.1186/s13643-017-0458-y.
  • [10] Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GW, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003 May 13;60(9):1424-8. doi: 10.1212/01.wnl.0000063305.61050.e6
  • [11] Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh ER. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus. 2016 Feb; 8(2): e498. doi: 10.7759/cureus.498.
  • [12] Moser N, Mior S, Noseworthy M, Côté P, Wells G, Behr M, et al. Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial. BMJ Open. 2019; 9(5): e025219. doi: 10.1136/bmjopen-2018-025219.
  • [13] Biller J, Sacco RL, Albuquerque FC, Demaerschalk BM, Fayad P, Long PH, et al. American Heart Association Stroke Council. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the american heart association/american stroke association. Stroke. 2014 Oct;45(10):3155-74. doi: 10.1161/STR.0000000000000016.
Year 2020, Volume: 11 Issue: 4, 98 - 100, 28.12.2020
https://doi.org/10.33706/jemcr.789735

Abstract

Project Number

-

References

  • [1] Rothwell DM, Bondy SJ, Williams JI. Chiropractic manipulation and stroke: a population- based case-control study. Stroke. 2001 May;32(5):1054-60. doi: 10.1161/01.str.32.5.1054.
  • [2] Haldeman S, Kohlbeck FJ, McGregor M. Stroke, cerebral artery dissection, and cervical spine manipulation therapy. J Neurol. 2002 Aug;249(8):1098-104. doi: 10.1007/s00415-002-0783-4.
  • [3] Albuquerque FC, Hu YC, Dashti SR, Abla AA, Clark JC, Alkire B, et al. Craniocervical arterial dissections as sequelae of chiropractic manipulation: patterns of injury and management. J Neurosurg. 2011 Dec;115(6):1197-1205. doi: 10.3171/2011.8.JNS111212.
  • [4] Mukherjee ST. Cervical Manipulation Leading to Cerebellar Stroke in a Pilot. Aerosp Med Hum Perform. 2015 Dec;86(12):1066-9. doi: 10.3357/AMHP.4400.2015.
  • [5] Kowlgi NG, Gowani SA, Mota P, Haider J. Self-inflicted vertebral artery dissection: a case report and review of literature. Conn Med. 2013 Oct;77(9):551-2. PMID: 24266133
  • [6] Jeret JS, Bluth M. Stroke following chiropractic manipulation. Report of 3 cases and review of the literature. Cerebrovasc Dis. 2002;13(3):210-3. doi: 10.1159/000047778
  • [7] Jeong DK, Hwang SK. A Case of Posterior Inferior Cerebellar Artery Infarction after Cervical Chiropractic Manipulation. Korean J Neurotrauma. 2018 Oct;14(2):159-163. doi: 10.13004/kjnt.2018.14.2.159.
  • [8] Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, et al. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap. 2017 Nov 22;25:35. doi: 10.1186/s12998-017-0165-8.
  • [9] Nielsen SM, Tarp S, Christensen R, Bliddal H, Klokker L, Henriksen M. The risk associated with spinal manipulation: an overview of reviews. Syst Rev. 2017 Mar 24;6(1):64. doi: 10.1186/s13643-017-0458-y.
  • [10] Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GW, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003 May 13;60(9):1424-8. doi: 10.1212/01.wnl.0000063305.61050.e6
  • [11] Church EW, Sieg EP, Zalatimo O, Hussain NS, Glantz M, Harbaugh ER. Systematic Review and Meta-analysis of Chiropractic Care and Cervical Artery Dissection: No Evidence for Causation. Cureus. 2016 Feb; 8(2): e498. doi: 10.7759/cureus.498.
  • [12] Moser N, Mior S, Noseworthy M, Côté P, Wells G, Behr M, et al. Effect of cervical manipulation on vertebral artery and cerebral haemodynamics in patients with chronic neck pain: a crossover randomised controlled trial. BMJ Open. 2019; 9(5): e025219. doi: 10.1136/bmjopen-2018-025219.
  • [13] Biller J, Sacco RL, Albuquerque FC, Demaerschalk BM, Fayad P, Long PH, et al. American Heart Association Stroke Council. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the american heart association/american stroke association. Stroke. 2014 Oct;45(10):3155-74. doi: 10.1161/STR.0000000000000016.
There are 13 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Enis Ademoğlu 0000-0002-6330-666X

Mehmet Muzaffer İslam 0000-0001-6928-2307

Gökhan Aksel 0000-0002-5580-3201

Serkan Emre Eroğlu 0000-0002-3183-3713

Project Number -
Publication Date December 28, 2020
Submission Date September 2, 2020
Published in Issue Year 2020 Volume: 11 Issue: 4

Cite

APA Ademoğlu, E., İslam, M. M., Aksel, G., Eroğlu, S. E. (2020). An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report. Journal of Emergency Medicine Case Reports, 11(4), 98-100. https://doi.org/10.33706/jemcr.789735
AMA Ademoğlu E, İslam MM, Aksel G, Eroğlu SE. An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report. Journal of Emergency Medicine Case Reports. December 2020;11(4):98-100. doi:10.33706/jemcr.789735
Chicago Ademoğlu, Enis, Mehmet Muzaffer İslam, Gökhan Aksel, and Serkan Emre Eroğlu. “An Unusual Occurrence of Acute Cerebellar Infarct After Self-Cervical Manipulation: A Case Report”. Journal of Emergency Medicine Case Reports 11, no. 4 (December 2020): 98-100. https://doi.org/10.33706/jemcr.789735.
EndNote Ademoğlu E, İslam MM, Aksel G, Eroğlu SE (December 1, 2020) An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report. Journal of Emergency Medicine Case Reports 11 4 98–100.
IEEE E. Ademoğlu, M. M. İslam, G. Aksel, and S. E. Eroğlu, “An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report”, Journal of Emergency Medicine Case Reports, vol. 11, no. 4, pp. 98–100, 2020, doi: 10.33706/jemcr.789735.
ISNAD Ademoğlu, Enis et al. “An Unusual Occurrence of Acute Cerebellar Infarct After Self-Cervical Manipulation: A Case Report”. Journal of Emergency Medicine Case Reports 11/4 (December 2020), 98-100. https://doi.org/10.33706/jemcr.789735.
JAMA Ademoğlu E, İslam MM, Aksel G, Eroğlu SE. An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report. Journal of Emergency Medicine Case Reports. 2020;11:98–100.
MLA Ademoğlu, Enis et al. “An Unusual Occurrence of Acute Cerebellar Infarct After Self-Cervical Manipulation: A Case Report”. Journal of Emergency Medicine Case Reports, vol. 11, no. 4, 2020, pp. 98-100, doi:10.33706/jemcr.789735.
Vancouver Ademoğlu E, İslam MM, Aksel G, Eroğlu SE. An unusual occurrence of acute cerebellar infarct after self-cervical manipulation: a case report. Journal of Emergency Medicine Case Reports. 2020;11(4):98-100.