Vertebral Artery Dissection

Opponents of Chiropractic have attempted a smear campaign over the last several years by suggesting that chiropractic adjustments to the neck increase the risk of a certain type of stroke. This campaign was never based upon any scientific evidence, but rather on biased opinions.

With countless hours of research, studies and documentation supporting Chiropractic, it is time to put those false accusations to rest and educate the public on how and why Chiropractic does not increase the risks of these types of problems.

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The major causes of stroke in young adults and children differ from those in older people. Dissection of the internal carotid and vertebral arteries in the neck accounts for about a fifth of strokes in the young compared with about 2.5% in older patients.

Dissection of intracranial blood vessels is rare and has a worse prognosis than extracranial dissections. Arterial dissection occurs when blood tracks into the vessel wall along a specific line of cleavage. This may be subintimal, causing luminal narrowing or occlusion, or subadventitial, when a pseudoaneurysm may form. The cause is rarely established and may differ according to the artery affected. The incidence of arterial dissection is increased in patients with fibromuscular dysplasia, migraine, or hypertension; in smokers; and in those taking oral contraceptives. It is commonly associated with trauma to the neck.

 

VAD Chart


Patients with dissection of the arteries in the neck may present with any combination of craniocervical pain (in 50-80% of cases), cerebral ischaemia, cranial nerve palsy, Horner's syndrome, and pulsatile tinnitus. Pain often precedes neurological features, usually by hours or days but occasionally by weeks. The pain has been described as stabbing, pulsating, aching, "thunderclap," sharp, or "unusual." It is usually localised to the neck, head, eye, or face, with some tendency for the pain of carotid artery dissection to localise anteriorly and that of the vertebral artery to localise posteriorly. Dissection of the major arteries in the neck is an important and probably underdiagnosed cause of stroke and craniocervical head pain.

Studies reveal the slight correlation between Chiropractic patients and stroke is likely due to patients experiencing headache and neck pain from VAD and seeking care before their stroke.

 

Much of OCA's research and information can also be found on the following websites:

Chiropractic is Safe!

International Chiropractors Association

American Chiropractic Association