Vertebral artery dissection and stroke following neck manipulation by Native American healer

Stroke as a complication of cervical manipulation and dissection of the vertebral artery is rare but has been well described1 and is most commonly associated with chiropractic manipulation of the neck using a technique often called “high velocity thrust.”2 Strokes from vertebral artery dissections have also been reported with cervical self-manipulation and other causes of neck trauma such as sports and roller coasters. The authors report on a patient with vertebral artery dissection and a stroke occurring after a Native American healing ceremony. This previously healthy 32-year-old woman from the Pueblo of Zuni presented with the sudden onset of vertigo, left-sided ataxia, and vomiting. Six days before the onset of her symptoms, the patient underwent a healing ceremony with a native healer whom she referred to as a “bone setter” for complaints of nontraumatic left shoulder discomfort. During the ceremony, she underwent vigorous manipulation of her neck with a sudden thrusting of the head upward and to the right while her left shoulder was being held to the ground. She noted neck discomfort immediately afterward, which persisted. She awoke …