Stroke Following Chiropractic Manipulation of the Spine

STROKE has been previously described as a complication of chiropractic manipulation of the head and neck. The reported cases are notable in two respects. First, the affected patients are predominantly young (under 40 years of age) and have no demonstrable coexisting vascular disease. Second, premonitory symptoms of vertebrobasilar ischemia during neck manipulation were simply not recognized as an absolute contraindication to further mechanotherapy. We wish to reemphasize this avoidable syndrome. Report of Cases Case 1.— A 52-year-old woman complained of weakness on the left side of 24 hours' duration. One month earlier she had begun a series of chiropractic manipulations because of recurrent neck pain that had started after minor injury ten years before. During several of these treatments, she experienced transient vertigo associated with nausea, blurred vision, and scintillating scotomata without loss of vision or headache. Near the end of her last treatment, following a painful rotation of the