title: Cerebrovascular accident without chiropractic manipulation: a case report.
abstract: OBJECTIVE
  To discuss the case of a patient with chronic headache. Although not in severe pain at time of consultation, signs and symptoms raised concern. The patient later had a cerebrovascular accident.
  
  
  METHODS
  A 49-year-old man with non-traumatic chronic episodic head and neck pain presented for care. Examination and plain film radiographs were unremarkable, suggesting a mechanical origin for the symptoms; however, information in the case history raised concerns.
  
  
  RESULTS
  The patient was examined and not manipulated by the doctor of chiropractic but referred back to his general practitioner for a second opinion. The following week, the patient was admitted to hospital having had a cerebrovascular accident.
  
  
  CONCLUSIONS
  The possible indication of the prodrome to a stroke may lie in the case history rather than the examination findings and provocative testing.
authors.affiliation: Welsh Institute of Chiropractic, School of Applied Sciences, University of Glamorgan, Pontypridd, Rhondda Cynon Taff, Wales, UK.
authors.forename: Annabel L
authors.initials: AL
authors.lastname: Kier
authors.forename: Peter W
authors.initials: PW
authors.lastname: McCarthy
mesh_terms: D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000209:etiology; D020521:Stroke / Q000175:diagnosis