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Article ID	#21295
Title	Current understanding of the relationship between cervical manipulation and stroke: What does it mean for the chiropractic profession?
URL	http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922298/
Journal	Chiropr & Osteopat. 2010 ;18(1):Online access only 30 p
Author(s)	Murphy DR
Subject(s)	Manipulation, Cervical / adverse effects Stroke Vertebral Artery Dissection
Peer Review	Yes
Publication Type	Article
Abstract/Notes	The understanding of the relationship between cervical manipulative therapy (CMT) and vertebral artery dissection and stroke (VADS) has evolved considerably over the years. In the beginning the relationship was seen as simple cause-effect, in which CMT was seen to cause VADS in certain susceptible individuals. This was perceived as extremely rare by chiropractic physicians, but as far more common by neurologists and others. Recent evidence has clarified the relationship considerably, and suggests that the relationship is not causal, but that patients with VADS often have initial symptoms which cause them to seek care from a chiropractic physician and have a stroke some time after, independent of the chiropractic visit. This new understanding has shifted the focus for the chiropractic physician from one of attempting to "screen" for "risk of complication to manipulation" to one of recognizing the patient who may be having VADS so that early diagnosis and intervention can be pursued. In addition, this new understanding presents the chiropractic profession with an opportunity to change the conversation about CMT and VADS by taking a proactive, public health approach to this uncommon but potentially devastating disorder. This abstract is reproduced with the permission of the publisher; click on the above link for free full text.

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