title: Patients with symptoms and signs of stroke presenting to a rural chiropractic practice.
abstract: OBJECTIVE
  The purpose of this article was to present a retrospective case series of patients with symptoms and signs suggesting a stroke or prodrome and discuss the potential for health education and promotion initiatives in chiropractic that might affect this serious disease.
  
  
  METHODS
  A database and hand search of records from a rural Mississippi chiropractic practice was performed to identify all cases of patients presenting with symptoms and signs of stroke during the past 4 years, as well as stroke mortality among active patients during the same period.
  
  
  RESULTS
  Six subjects met inclusion criteria of about 500 active patients during any given year of the 4-year study period, including patients who had stroke symptoms or signs (n = 4) or who died as a result of stroke without presenting to the office (n = 2). Records and magnetic resonance angiograms were obtained after referral was made for a 77-year-old white female, 71-year-old white male, 59-year-old white male, and 24-year-old Hispanic female. Three of the 4 surviving patients were eventually diagnosed with stroke, and one with seizure disorder. Common presenting complaints were unilateral arm weakness and slurred speech; other complaints included episodic loss of vision, dysphagia, dysphonia, and same-sided leg weakness.
  
  
  CONCLUSIONS
  Patients with symptoms and signs of stroke may infrequently present to chiropractic physicians for evaluation and treatment. Prevention, screening, early identification of stroke symptoms and signs, and referral for prompt treatment are cornerstones of the national stroke policy as espoused by the Centers for Disease Control. Chiropractic physicians have opportunities for practice-related health education initiatives focusing on the role of health and wellness in stroke prevention and for prompt lifesaving referral of emergency presentations.
authors.affiliation: National University of Health Sciences, Starkville, MS, USA. rl@drleach.com
authors.forename: Robert A
authors.initials: RA
authors.lastname: Leach
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000175:diagnosis; D002684:Chiropractic / Q000193:education; D004517:Education, Professional; D004632:Emergency Medical Services; D004827:Epilepsy / Q000175:diagnosis; D005260:Female; D006266:Health Education; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012106:Research; D012189:Retrospective Studies; D012424:Rural Population; D020521:Stroke / Q000175:diagnosis* / Q000517:prevention & control; D055815:Young Adult