Wang J L, Lin J J, Lin J C, Lie C C, Shih T P, Tsao W L
Department of Family Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 Jun;55(6):496-500.
A 32-year-old healthy man developed vomiting, blurred vision, and consciousness disturbance following cervical manipulation. Physical examination showed stuporous consciousness and spontaneous horizontal nystagmus. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain revealed infarction in the territory of the basilar artery. Studies of MR angiography and vertebral angiography disclosed dissection of the right vertebral artery at the atlantoaxial segment. Antiedematous drugs were prescribed and the patient gradually improved. Neurologic examination six months later demonstrated mild cerebellar ataxia. Physicians and patients should be aware that vertebro-basilar dissection may follow cervical manipulation, and, more importantly, should attempt to prevent progressive infarction.
一名32岁健康男性在颈椎推拿后出现呕吐、视力模糊和意识障碍。体格检查显示意识不清和自发性水平眼球震颤。脑部计算机断层扫描（CT）和磁共振成像（MR）显示基底动脉供血区梗死。磁共振血管造影和椎动脉造影研究显示右椎动脉在寰枢椎节段夹层分离。给予了抗水肿药物，患者逐渐好转。6个月后的神经学检查显示轻度小脑共济失调。医生和患者应意识到颈椎推拿后可能发生椎基底动脉夹层分离，更重要的是，应试图预防梗死进展。
