Symptoms of neck artery compromise: case presentations of risk estimate for treatment.
OBJECTIVE
To discuss the use of magnetic resonance angiography (MRA) imaging as a definitive means to assess vascular patency and the relative value of various vertebral artery screening maneuvers.


METHODS
Two female patients suffered head and neck trauma with possible vertebral artery insufficiency. Positive vertebral artery screening tests with consistent symptoms were present in both cases. One patient had a congenitally narrowed vertebral artery, whereas the second had no evidence of vascular anomaly.


RESULTS
Conservative chiropractic management using manipulation and rehabilitation led to favorable outcome in both cases. The patient with vascular compromise received a treatment plan avoiding neck manipulation. The second case received manipulation per clinical indications from neck findings.


CONCLUSIONS
MRA imaging may be more important to critical decision making than are the various vertebral artery screening tests in patients with positional vertigo on combined neck extension and rotation.
Combs
S B
SB
Institute for Spine and Biomedical Research, Plano, Texas, USA.
Triano
J J
JJ
D000328:Adult; D002339:Carotid Arteries / Q000002:abnormalities; D002560:Cerebrovascular Circulation; D002684:Chiropractic; D000075202:Contraindications; D006259:Craniocerebral Trauma / Q000628:therapy*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D019838:Neck Injuries; D019547:Neck Pain / Q000175:diagnosis* / Q000628:therapy; D012307:Risk Factors; D014711:Vertebral Artery / Q000002:abnormalities*