title: [Bilateral vertebral artery dissection during chiropractic treatment].
abstract: A previously healthy 42-year-old man was brought to the emergency department after he became unwell during chiropractic treatment. During cervical manipulation he had experienced nausea, dizziness, and loss of vision. He arrived at the clinic initially totally blind and with dysarthria. Imaging showed a bilateral vertebral artery dissection, and an MRI scan carried out the next day showed extensive ischaemia in the vertebrobasilar territory. Complications from chiropractic treatment are rare but can be severe or, in some cases, even fatal, especially if treatment involves the cervical area. There is no controlled evidence showing that chiropractic treatment is beneficial and therefore we would not recommend it. Before treatment is commenced, patients should be informed of the risks of cervical chiropractic manipulation.
authors.affiliation: Erasmus MC-Centrum, afd. Neurologie, Rotterdam. k.kuitwaard@erasmusmc.nl
authors.forename: K
authors.initials: K
authors.lastname: Kuitwaard
authors.forename: H Z
authors.initials: HZ
authors.lastname: Flach
authors.forename: F
authors.initials: F
authors.lastname: van Kooten
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000009:adverse effects* / Q000592:standards; D012307:Risk Factors; D020217:Vertebral Artery Dissection / Q000209:etiology*