title: Chiropractic sympathectomy: carotid artery dissection with oculosympathetic palsy after chiropractic manipulation of the neck.
abstract: The clinical association between carotid artery dissection and oculosympathetic palsy is well-known. However, the occurrence of this combination with chiropractic manipulation of the cervical neck is rare. We describe the case of a 54-year-old Caucasian American male who underwent cervical manipulation for neck pain. The following day he noticed drooping of his left eyelid, with an unequal pupil size. Imaging later confirmed carotid artery dissection. Only three previous cases (one from the United States ), of an association between carotid artery dissection and chiropractic sympathectomy (oculosympathetic palsy after chiropractic manipulation of the neck) have been reported. Pictures of the oculosympathetic palsy, computed tomography of the head and magnetic resonance imaging of the dissection are presented.
authors.affiliation: VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA.
authors.forename: Amir M
authors.initials: AM
authors.lastname: Khan
authors.forename: Nissar
authors.initials: N
authors.lastname: Ahmad
authors.forename: Xe
authors.initials: X
authors.lastname: Li
authors.forename: Mark A
authors.initials: MA
authors.lastname: Korsten
authors.forename: Alan
authors.initials: A
authors.lastname: Rosman
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D020215:Carotid Artery, Internal, Dissection / Q000188:drug therapy / Q000209:etiology*; D006493:Heparin / Q000627:therapeutic use; D006732:Horner Syndrome / Q000209:etiology; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000009:adverse effects*; D008875:Middle Aged; D019547:Neck Pain / Q000628:therapy*
chemical_list: D000925:Anticoagulants; D006493:Heparin