ASSOCIATION OF INTERNAL CAROTID ARTERY DISSECTION AND CHIROPRACTIC MANIPULATION
- 1 January 2003
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Neurologist
- Vol. 9 (1), 35-44
- https://doi.org/10.1097/01.nrl.0000038583.58012.10
Abstract
To determine the relationship between chiropractic manipulative therapy and internal carotid artery dissection, a MEDLINE literature search was performed for the years 1966 through 2000 using the terms internal carotid dissection. Literature that included information concerning causation of ICAD, as well as all case studies and series, was selected for review. In reviewing the cases of internal carotid dissection potentially related to CMT, there were many confounding factors, such as connective tissue aberrations, underlying arteriopathy, or coexistent infection, that obscured any obvious cause-and-effect relationship. To date there are only 13 reported cases of ICAD temporally related to CMT. Most ICADs seem to occur spontaneously and progress from local symptoms of headache and neck pain to cortical ischemic signs. Approximately one third of the reported cases were manipulated by practitioners other than chiropractic physicians, and because of the differential risk related to major differences in training and practice between practitioners who manipulate the spine, it would be inappropriate to compare adverse outcomes between practitioner groups. The medical literature does not support a clear causal relationship between CMT and ICAD. Reported cases are exceedingly scarce, and none support clear cause and effect.Keywords
This publication has 64 references indexed in Scilit:
- Carotid Artery DissectionAnnual Review of Medicine, 2000
- Vertebral and carotid artery dissection following chiropractic cervical manipulationNeurosurgical Review, 1999
- Internal Carotid Artery Dissection Following Rigid EsophagoscopyJAMA Otolaryngology–Head & Neck Surgery, 1999
- Neurologic complications following chiropractic manipulationNeurology, 1995
- Traumatic dissections of the extracranial internal carotid arteryJournal of Neurosurgery, 1988
- Pathology of Spontaneous Dissection of Intracranial ArteriesCanadian Journal of Neurological Sciences, 1987
- Spontaneous dissection of the cervical internal carotid arteryAnnals of Neurology, 1986
- Injury of the carotid and vertebral arteriesNeuroradiology, 1983
- DISSECTING HEMATOMA OF THE INTERNAL CAROTID ARTERY FOLLOWING CHIROPRACTIC CERVICAL MANIPULATIONJournal Of Trauma-Injury Infection and Critical Care, 1977
- Spontaneous Dissection of the Internal Carotid ArteryArchives of Surgery, 1976