title: Cerebrospinal fluid leak secondary to chiropractic manipulation.
abstract: BACKGROUND
  There is a paucity of quality data on the incidence of adverse outcomes of chiropractic manipulation. Spontaneous intracranial hypotension (SIH) subsequent to cervical spinal manipulation has been documented. However, no imaging correlates have previously been presented demonstrating a clear causal relationship to manipulation with follow-up and correlating with clinical symptomatology.
  
  
  METHODS
  We present a case of subacute cervical cerebrospinal fluid (CSF) leak resulting from chiropractic manipulation of the cervical spine. The patient is a 29-year-old female who received manipulation one week prior to developing symptoms of severe orthostatic headache, nausea, and vomiting. Magnetic resonance imaging (MRI) revealed a new C5-C6 ventral CSF collection. Symptomatic onset corresponded with the recent cervical chiropractic adjustment. We present serial imaging correlating with her symptomatology and review the pertinent literature on complications of chiropractic manipulation.
  
  
  CONCLUSIONS
  Our case of ventral CSF leak with symptoms of intracranial hypotension demonstrated spontaneous symptomatic resolution without permanent neurological sequelae.
authors: Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA.
authors: Nicholas A
authors: NA
authors: Kusnezov
authors: Shamsha A
authors: SA
authors: Velani
authors: Daniel C
authors: DC
authors: Lu
keywords: Cerebrospinal fluid leak; chiropractic manipulation; intracranial hypotension
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