Occipital infarction following chiropractic cervical manipulation.
A 44-year-old man developed a complete homonymous hemianopia 2 days after undergoing chiropractic cervical manipulation. Thromboembolism from the vertebrobasilar circulation--as the consequence of trauma to the vertebral arteries by adjacent bones, muscles, and ligaments during twisting and extension of the neck--is the probable mechanism for occipital infarction and other strokes in this and previous cases. Other neuroophthalmic manifestations reported include Horner's syndrome and sixth nerve and gaze palsies.
D000328:Adult; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D002684:Chiropractic / Q000379:methods*; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000009:adverse effects*; D009333:Neck; D009778:Occipital Lobe; D014057:Tomography, X-Ray Computed