Szafran Kevin, Zheng YuanDian, Butensky Forrest
Physical Medicine and Rehabilitation, American University of the Caribbean School of Medicine, Florida, USA.
Family Medicine, Nassau University Medical Center, New York, USA.
Cureus. 2025 Jul 10;17(7):e87689. doi: 10.7759/cureus.87689. eCollection 2025 Jul.
Vertebral artery dissection (VAD) is a rare but potentially serious cause of posterior circulation stroke, occasionally associated with high-velocity, low-amplitude cervical spinal manipulation therapy (CSMT). We present the case of a 70-year-old female who developed acute expressive aphasia following chiropractic neck manipulation. Imaging revealed a proximal right vertebral artery occlusion with findings suggestive of dissection in the setting of vascular hypoplasia. The patient was managed conservatively with blood pressure control, antithrombotic therapy, and rehabilitation, ultimately returning to near-baseline function. This case highlights the importance of recognizing VAD as a potential complication of cervical manipulation and underscores the value of early diagnosis, thorough vascular imaging, and multidisciplinary management.
椎动脉夹层（VAD）是后循环卒中的一种罕见但可能严重的病因，偶尔与高速、低振幅的颈椎整骨疗法（CSMT）有关。我们报告一例70岁女性在接受脊椎按摩师颈部推拿后出现急性表达性失语的病例。影像学检查显示右侧椎动脉近端闭塞，在血管发育不全的情况下有提示夹层的表现。患者通过血压控制、抗栓治疗和康复进行保守治疗，最终恢复到接近基线的功能。该病例强调了认识到VAD作为颈椎推拿潜在并发症的重要性，并强调了早期诊断、全面血管成像和多学科管理的价值。
