Braune H J, Munk M H, Huffmann G
Neurologische Universitätsklinik mit Poliklinik, Marburg.
Dtsch Med Wochenschr. 1991 Jul 5;116(27):1047-50. doi: 10.1055/s-2008-1063715.
Chiropractic manipulation of the neck can occasionally cause severe neurological complications, as demonstrated by this case report. A 59-year-old man who had previously sustained a cardiac infarction and a femoral-popliteal bypass operation, suffered from painful spasms of the cervical muscles for several weeks. After chiropractic manipulation, a left, predominantly brachiofacial, hemiparesis developed during the subsequent 24 hours. Computed tomography demonstrated a recent infarction in the area supplied by the ascending central and parietal branches of the right medial cerebral artery. Doppler sonography revealed occlusion of the right internal carotid artery as the cause. Marked improvement followed hypervolaemic haemodilution daily with 500 ml hydroxyethyl starch and intensive physiotherapy. Blood flow through the internal carotid artery was restored after seven days (demonstrated by Doppler ultrasound). In the presence of arteriosclerotic vessel changes particular care should be exercised in deciding on and execution of chiropractic manipulations.
正如本病例报告所示，颈部整脊推拿偶尔会导致严重的神经并发症。一名59岁男性，既往有心肌梗死和股腘动脉搭桥手术史，颈部肌肉疼痛性痉挛数周。整脊推拿后，在随后的24小时内出现左侧（主要为臂面部）偏瘫。计算机断层扫描显示右侧大脑中动脉中央升支和顶叶分支供血区域有近期梗死灶。多普勒超声检查显示右侧颈内动脉闭塞为病因。每天用500毫升羟乙基淀粉进行高容量血液稀释并强化物理治疗后，病情明显改善。7天后颈内动脉血流恢复（多普勒超声证实）。对于存在动脉硬化血管改变的患者，在决定和实施整脊推拿时应格外小心。
