Review

Cerebrovascular Complications of Neck Manipulation
Maurizio Paciaroni^a, Julien Bogousslavsky<sup>b

a</sup>Stroke Unit, Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy;
^bDepartment of Neurology and Neurorehabilitation, Swiss Medical Network, Valmont-Genolier, Glion sur Montreux, Switzerland

Address of Corresponding Author

Eur Neurol 2009;61:112-118 (DOI: 10.1159/000180314)

  Key Words

• Neck manipulation
• Cerebrovascular complications
• Artery dissection
• Neck pain
• Chiropractic therapy

  Abstract

The safety of spinal manipulation is an issue that demands regular and rigorous assessment, as manipulation of the upper spine has been associated with serious adverse events such as cerebrovascular accidents due to cervical artery dissection. A correlation between stroke and cervical manipulation has been reported with increasing frequency, and each new report seems to reignite debate between neurologists and manual therapists. Specific risk factors for cerebrovascular complications related to spinal manipulation have not been identified yet; for this reason, any patient may be at risk, particularly those below 45 years of age. Patients undergoing spinal manipulative therapy need to consent to the possible risk of stroke or vascular injury from the procedure.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Maurizio Paciaroni
Stroke Unit, Division of Cardiovascular Medicine
Department of Internal Medicine, Santa Maria della Misericordia Hospital
University of Perugia, IT-06100 Perugia (Italy)
Tel./Fax +39 075 578 2765, E-Mail mpaciaroni@med.unipg.it

  Article Information

Received: July 8, 2008
Accepted: August 19, 2008
Published online: December 9, 2008
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 0, Number of References : 69