Cohen Fred L
Private Practice of Neurological Surgery, Palm Beach Gardens, Florida, United States; Gary Roberts and Associates, West Palm Beach, Florida, United States.
J Neurol Surg Rep. 2016 Oct;77(4):e162-e167. doi: 10.1055/s-0036-1597626.
Despite widespread utilization of chiropractic treatment for various ailments, there is a paucity of documentation regarding intracerebral hemorrhage related to chiropractic trauma. Stroke has been reported from cervical manipulation, although with a suggested low incidence. Activator treatment, an instrument that produces a high-velocity, low-amplitude impact to the spine, is considered especially safe. There are no prior reports of intracerebral hemorrhage resulting from a chiropractic activator treatment. A 75-year-old woman was admitted to the hospital with a history of headaches, visual difficulties on the right, and speech disturbance of relatively acute onset. CT scan showed a brain hemorrhage in an unusual location. Extensive evaluation was undertaken because this was thought to be a spontaneous event. No cause was found on imaging. Subsequent history revealed a chiropractic activator treatment applied directly to the junction of the back of her head and the upper cervical spine immediately prior to the onset of symptoms. Her clinical course is described. This appears to be the first report linking traumatic intracerebral hemorrhage with a chiropractic activator treatment. The use of this modality in an elderly population, with widespread utilization of anticoagulants and platelet inhibitors, is of potential concern.
尽管整脊疗法被广泛用于治疗各种疾病，但关于整脊创伤导致脑出血的文献却很少。有报道称颈椎推拿可引发中风，不过其发病率似乎较低。激活器疗法是一种对脊柱产生高速、低振幅冲击的器械，被认为特别安全。此前尚无整脊激活器疗法导致脑出血的报告。一名75岁女性因头痛、右侧视力障碍和相对急性起病的言语障碍病史入院。CT扫描显示脑出血位于一个不寻常的部位。由于认为这是一个自发事件，因此进行了广泛的评估。影像学检查未发现病因。随后的病史显示，在症状发作前，她的后脑勺与上颈椎交界处直接接受了整脊激活器治疗。描述了她的临床病程。这似乎是将创伤性脑出血与整脊激活器治疗联系起来的首例报告。在老年人群中使用这种疗法，同时广泛使用抗凝剂和血小板抑制剂，可能令人担忧。
