Chirotherapy Associated Vertebral Artery Dissection: Case Illustration and Literature Review

Vertebral artery dissection (VAD) is a rare but serious safety concern associated with spinal manipulative therapy. This report highlights the occurrence of such condition in a 35-year-old male without predisposing risk factors. The patient has had dizziness and occipital pain of new onset following chirotherapy for the neck spines. On admission, magnetic resonance angiography depicted a dissecting dilatation at the intracranial portion of the right vertebral artery. He was placed on antithrombotic therapy and fluid supplementation. His presenting symptoms completely remitted without recurrence. Follow-up images 4 months later showed resolution of the arterial dissection without progression to rupture. The study with featured images facilitates the physicians better understand VAD in those with neurologic complaints following chiropractic manipulation of the cervical vertebra.