[Horner's syndrome in dissection of the carotid artery after chiropractic manipulation].
METHODS
We report on a 37-year old patient with sudden onset of pain of the right scalp and an ipsilateral small pupil, presenting five weeks after chiropractic manipulation of the neck.


RESULTS
Pharmacologic pupil testing showed a postganglionic Horner's syndrome on the right side. Magnetic resonance angiography confirmed the diagnosis of a dissection of the right internal carotid artery at a subacute stage.


CONCLUSIONS
There appears to be a causal relationship between carotid artery dissection and the chiropractic manipulation of the cervical spine. Ophthalmological signs played the key role in detecting this complication.
Gamer
Daphne
D
Universitäts-Augenklinik Tübingen, Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie, Germany. daphne.gamer@med.uni-tuebingen.de
Schuster
Andreas
A
Aicher
Klaus
K
Apfelstedt-Sylla
Eckart
E
D000328:Adult; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D006732:Horner Syndrome / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D026882:Manipulation, Chiropractic / Q000009:adverse effects*