scholarly journals Massive hematothorax after thoracic spinal manipulation for acute thoracolumbar pain

2013 ◽  
Vol 5 (3) ◽  
pp. 27 ◽  
Author(s):  
Johannes Struewer ◽  
Thomas Manfred Frangen ◽  
Ewgeni Ziring ◽  
Ulrike Hinterseher ◽  
Ilias Kirazidis
Keyword(s):  
Spinal Manipulation ◽  
Medical Literature ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Manual Treatment ◽  
Thoracic Spinal ◽  
Acute Patient ◽  
Patient Pain ◽  
Life Threatening ◽  
The One

Spinal manipulation usually represents a widely used and effective method for physicians in order to relieve acute patient pain and muscular dysbalance. Although life-threatening complications (<em>e.g</em>. pneumothorax, vertebral artery dissection, stroke) after manual treatment are reported with regard to actual medical literature millions of patients undergo manual treatment to manage thoracolumbar pain each year. The authors present the case of a 17 year old male patient with a life-threatening hematothorax after thoracic high velocity spinal manipulation for acute thoracolumbar pain. The patient required emergency chest tube thoracostomy and afterwards thoracoscopic haemostasis for an intercostal venous lesion. A massive hematothorax after spinal manipulation represents an extremely rare but life-threatening complication. Physicians are encouraged to promote the benefits of manual/chiropratic therapy on the one hand but on the other hand are obliged to educate about potential serious dangers and adverse events.

scholarly journals Traumatic Vertebral Artery Dissection and Basilar Artery Occlusion/Stroke in a 7-Year-Old Child: A Case Report

2019 ◽  
Vol 08 (04) ◽  
pp. 233-237
Author(s):  
Binh Phung ◽  
Trusha Shah
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Basilar Artery ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Basilar Artery Occlusion ◽  
Left Vertebral Artery ◽  
Artery Dissection ◽  
Life Threatening ◽  
Computed Tomography Angiogram

AbstractVertebral artery dissection (VAD) followed by basilar artery occlusion/stroke (BAO/BAS) is a rare but potentially life-threatening complication. We present a case report of a 7-year-old boy with VAD complicated by BAO/BAS 4 days after falling off a scooter. Symptoms included left-sided weakness and facial droop preceded by a 20-minute episode of altered sensorium. Magnetic resonance imaging showed ischemic changes in the left posterior inferior cerebellum and right pons. Computed tomography angiogram confirmed dissection of the left vertebral artery with occlusion/thrombosis of the basilar artery. Heparinization for 96 hours, followed by 6 months of low-molecular weight heparin injection, resulted in improvement of his neurological symptoms.

scholarly journals Progressive Intracranial Vertebral Artery Dissection Presenting with Isolated Trigeminal Neuralgia-Like Facial Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Tomoki Nakamizo ◽  
Takashi Koide ◽  
Hiromichi Miyazaki
Keyword(s):  
Trigeminal Neuralgia ◽  
Vertebral Artery ◽  
Facial Pain ◽  
Brain Infarction ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Intracranial vertebral artery dissection (IVAD) is a potentially life-threatening disease, which usually presents with ischemic stroke or subarachnoid hemorrhage. IVAD presenting with isolated facial pain is rare, and no case with isolated trigeminal neuralgia- (TN-) like facial pain has been reported. Here, we report the case of a 57-year-old male with IVAD who presented with acute isolated TN-like facial pain that extended from his left cheek to his left forehead and auricle. He felt a brief stabbing pain when his face was touched in the territory of the first and second divisions of the left trigeminal nerve. There were no other neurological signs. Magnetic resonance imaging (MRI) of the brain 7 days after onset revealed dissection of the left intracranial vertebral artery without brain infarction. The pain gradually disappeared in approximately 6 weeks, and the patient remained asymptomatic thereafter, except for a brief episode of vertigo. Follow-up MRI revealed progressive narrowing of the artery without brain infarction. This case indicates that IVAD can present with isolated facial pain that mimics TN. IVAD should be considered in the differential diagnosis of acute facial pain or TN.

scholarly journals Neurological complications of cervical spine manipulation

2001 ◽  
Vol 94 (3) ◽  
pp. 107-110 ◽  
Author(s):  
Clare Stevinson ◽  
Will Honan ◽  
Brian Cooke ◽  
Edzard Ernst
Keyword(s):  
Cervical Spine ◽  
Spinal Manipulation ◽  
Vertebral Artery Dissection ◽  
Cervical Radiculopathy ◽  
Neurological Complications ◽  
Artery Dissection ◽  
Acute Subdural Haematoma ◽  
Cervical Spine Manipulation ◽  
The Uk

To obtain preliminary data on neurological complications of spinal manipulation in the UK all members of the Association of British Neurologists were asked to report cases referred to them of neurological complications occurring within 24 hours of cervical spine manipulation over a 12-month period. The response rate was 74%. 24 respondents reported at least one case each, contributing to a total of about 35 cases. These included 7 cases of stroke in brainstem territory (4 with confirmation of vertebral artery dissection), 2 cases of stroke in carotid territory and 1 case of acute subdural haematoma. There were 3 cases of myelopathy and 3 of cervical radiculopathy. Concern about neurological complications following cervical spine manipulation appears to be justified. A large long-term prospective study is required to determine the scale of the hazard.

scholarly journals Sulcal artery syndrome presenting as an incomplete Brown–Sequard syndrome – Report of an unusual case and review of the literature

2020 ◽  
Vol 29 (1) ◽  
pp. 59-63
Author(s):  
May Myat Win ◽  
Monica Saini ◽  
Shrikant Digambarrao Pande ◽  
Kappaganthu Venkatesh Prasanna
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Vertebral Artery Dissection ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Artery Dissection ◽  
Spinal Cord Infarction ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Brown Sequard Syndrome

Sulcal arteries perfuse the anterior two-thirds of the spinal cord, and spinal cord infarction as a result of sulcal artery occlusion is rare. Most reported cases are associated with vertebral artery dissection, and commonly involve the cervical spinal cord. A 74-year-old man presented with sudden onset weakness and numbness after a brief bout of abdominal pain. Further investigations concluded that this was sulcal artery syndrome. We report a case of sulcal artery syndrome affecting the thoracic spinal cord presenting as Brown–Sequard syndrome. Sulcal artery syndrome usually has good prognoses, unlike anterior spinal artery infarction.

scholarly journals Adverse effects of spinal manipulation: a systematic review

2007 ◽  
Vol 100 (7) ◽  
pp. 330-338 ◽  
Author(s):  
E Ernst
Keyword(s):  
Systematic Review ◽  
Adverse Effects ◽  
Vertebral Artery ◽  
Spinal Manipulation ◽  
Case Reports ◽  
Vertebral Artery Dissection ◽  
Case Series ◽  
Case Control ◽  
Artery Dissection ◽  
Case Control Studies

Objective To identify adverse effects of spinal manipulation. Design Systematic review of papers published since 2001. Setting Six electronic databases. Main outcome measures Reports of adverse effects published between January 2001 and June 2006. There were no restrictions according to language of publication or research design of the reports. Results The searches identified 32 case reports, four case series, two prospective series, three case-control studies and three surveys. In case reports or case series, more than 200 patients were suspected to have been seriously harmed. The most common serious adverse effects were due to vertebral artery dissections. The two prospective reports suggested that relatively mild adverse effects occur in 30% to 61 % of all patients. The case-control studies suggested a causal relationship between spinal manipulation and the adverse effect. The survey data indicated that even serious adverse effects are rarely reported in the medical literature. Conclusions Spinal manipulation, particularly when performed on the upper spine, is frequently associated with mild to moderate adverse effects. It can also result in serious complications such as vertebral artery dissection followed by stroke. Currently, the incidence of such events is not known. In the interest of patient safety we should reconsider our policy towards the routine use of spinal manipulation.

Preferential involvement of hypoplastic vessels in vertebral artery dissection: a comparative study

2011 ◽  
Vol 42 (01) ◽  
Author(s):  
R.J. Strege ◽  
P. Hohnstädt ◽  
H. Schindler ◽  
T. Vestring ◽  
R. Kiefer
Keyword(s):  
Comparative Study ◽  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection

Cervical Myelopathy as a Complication of Untreated Motor Tics: A Cautionary Tale

2020 ◽  
Author(s):  
Mariam Hull ◽  
Mered Parnes
Keyword(s):  
Cervical Myelopathy ◽  
Management Strategies ◽  
Vertebral Artery Dissection ◽  
Tic Disorders ◽  
Artery Dissection ◽  
Cautionary Tale ◽  
Eye Injuries ◽  
Tic Disorder ◽  
Aggressive Management ◽  
Motor Tics

AbstractTic disorders are common, affecting approximately 0.5 to 1% of children and adolescents. Treatment is required only when symptoms are bothersome or impairing to the patient, so many do not require intervention. However, on occasion tics may cause significant morbidity and are referred to as “malignant.” These malignant tics have resulted in cervical myelopathy, subdural hematoma secondary to head banging, biting of lips leading to infection of oral muscles, self-inflicted eye injuries leading to blindness, skeletal fractures, compressive neuropathies, and vertebral artery dissection. We describe a case of malignant tic disorder, with accompanying video segment, resulting in cervical myelopathy and quadriparesis in a child. We also discuss aggressive management strategies for neurologists to prevent potential lifelong disability. This case emphasizes that these malignant tics must be treated with all due haste to prevent such complications.

Radiological Findings of Vertebral Artery Dissection

1995 ◽  
Vol 33 (4) ◽  
pp. 507
Author(s):  
Ik Won Kang ◽  
Kil Woo Lee ◽  
Ji Hun Kim ◽  
Hong Kil Suh ◽  
Kyu Sun Kim ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Vertebral Artery Dissection ◽  
Artery Dissection ◽  
Radiological Findings
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