Cervical Artery Dissection

Vertebrobasilar stroke following manipulation is a topic that has generated great interest in the medical literature and popular media. A thorough discussion of the topic is covered based upon the scientific evidence and a review and analysis of the American Heart Association/American Stroke Association Scientific Statement is presented. Prevention and action steps if this tragic event occurs in the chiropractic physician's office is also covered.

• •Identify the anatomical and biomechanical risk factors associated with cervical artery dissection (CAD) during spinal manipulation
• •Understand the pathophysiology of vertebrobasilar stroke and the role of cervical manipulation as a potential triggering mechanism
• •Recognize clinical warning signs and red flag symptoms that may indicate arterial dissection or impending stroke
• •Apply evidence-based screening protocols and patient assessment strategies to reduce dissection risk prior to cervical manipulation
• •Review key findings and clinical recommendations from the American Heart Association/American Stroke Association Scientific Statement on manipulation and stroke risk
• •Develop an emergency action plan for immediate recognition and appropriate response if vertebrobasilar stroke occurs in the clinical setting
• •Evaluate current literature on the incidence and causation debate surrounding manipulation-associated dissection