Stroke after chiropractic manipulation as a result of extracranial postero-inferior cerebellar artery dissection.
OBJECTIVE
To describe a case of dissection of the postero-inferior cerebellar artery (PICA) after cervical manipulation.


METHODS
After cervical manipulation, a 42-year-old woman had a cerebellar syndrome related to an infarct in the area supplied by the PICA, confirmed by computed tomography of the brain. Cerebral angiography showed a normal appearance of the vertebral artery, a cervical extradural origin of PICA, and a dissection of the latter at the C1-C2 level.


RESULTS
Anticoagulant treatment with heparin was implemented. A positive outcome was achieved after 3 weeks.


CONCLUSIONS
Anatomical variations of the vertebral arteries and their branches are not infrequent and may constitute a predisposing factor to complications after neck manipulation.
Sédat
J
J
Department of Neuroradiology, CHU de Nice, Hôpital St. Roch, Nice, France. jsedat@yahoo.fr
Dib
M
M
Mahagne
M H
MH
Lonjon
M
M
Paquis
P
P
D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000209:etiology; D000925:Anticoagulants / Q000008:administration & dosage; D002531:Cerebellum / Q000098:blood supply*; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000209:etiology; D026882:Manipulation, Chiropractic / Q000009:adverse effects*; D020521:Stroke / Q000188:drug therapy / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin