Sinel M, Smith D
Department of Physical Medicine and Rehabilitation, Veterans Administration Medical Center, West Los Angeles, CA.
Arch Phys Med Rehabil. 1993 May;74(5):543-6. doi: 10.1016/0003-9993(93)90122-q.
Vertebrobasilar infarction is a well documented complication of cervical manipulation. A commonly proposed pathogenesis is an intimal tear of the vertebral artery leading to cerebellar and other posterior fossa lesions. However, there have been no cases of thalamic infarct reported. This case demonstrates a thalamic infarction concurrent with brainstem and cerebellar infarction secondary to cervical manipulation and intimal tearing of the vertebral artery. Immediately following manipulation, the patient developed nystagmus, quadriparesis, and a speech deficit. After an aggressive course of in-patient rehabilitation, the patient progressed to a community ambulator with deficits in speech and perception. This case demonstrates one of the inherent risks associated with repetitive forceful cervical manipulation.
椎基底动脉梗死是颈椎推拿有充分文献记载的并发症。一种普遍提出的发病机制是椎动脉内膜撕裂导致小脑和其他后颅窝病变。然而，尚无丘脑梗死的病例报道。本病例显示了一例因颈椎推拿和椎动脉内膜撕裂继发脑干及小脑梗死并发丘脑梗死的情况。推拿后，患者立即出现眼球震颤、四肢瘫和言语障碍。经过积极的住院康复治疗，患者进展为能在社区行走，但存在言语和感知功能缺陷。本病例显示了重复性强力颈椎推拿相关的固有风险之一。
