Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Neck manipulation may be associated with stroke

13.08.2014

Treatments that involve neck manipulation may be associated with strokes, although this association is not proven, according to an American Heart Association Scientific Statement written by lead author Dr. Jose Biller of Loyola University Medical Center and other stroke experts.

The statement, published in the heart association's journal Stroke, said it cannot be stated with certainty that neck manipulation causes strokes.

But a small tear in a neck artery, called a cervical dissection, is among the most common causes of strokes in young and middle-aged adults. A dissection can lead to a blood clot that travels to the brain and triggers a stroke.

"Most dissections involve some trauma, stretch or mechanical stress," Biller said. "Sudden movements that can hyperextend or rotate the neck -- such as whiplash, certain sports movements, or even violent coughing or vomiting -- can result in a cervical dissection, even if they are deemed inconsequential by the patient."

... more about:
»Health »blood »cervical »movements »neck »pain »spine »stroke »symptoms »therapy

Although techniques for cervical manipulative therapy vary, some maneuvers used by health practitioners also extend and rotate the neck, and sometimes involve a forceful thrust.

"Although a cause-and-effect relationship between these therapies and cervical dissection has not been established and the risk is probably low, a dissection can result in serious neurological injury," Biller said. "Patients should be informed of this association before undergoing neck manipulation."

Biller is chair of the Department of Neurology of Loyola University Chicago Stritch School of Medicine. He is an internationally known expert on strokes, especially strokes in children and young adults.

The association between cervical artery dissection and cervical manipulative therapies was identified in case control studies, which aren't designed to prove cause and effect.

Thus, it's not clear whether other factors could account for the apparent association between manipulative therapy of the neck and a greater incidence of cervical dissection/stroke. The relationship is difficult to evaluate because patients who are beginning to have a cervical artery dissection may seek treatment to relieve neck pain.

You should seek emergency medical evaluation if you develop neurological symptoms after neck manipulation or trauma, such as:

  • Pain in the back of your neck or in your head
  • Dizziness/vertigo
  • Double vision
  • Unsteadiness when walking
  • Slurred speech
  • Nausea and vomiting
  • Jerky eye movements or other eye movement disorders
  • Limb weakness on one or both sides
  • Disorientation, memory loss or altered level of consciousness

"Tell the physician if you have recently had a neck trauma or neck manipulation," Biller said. "Some symptoms, such as dizziness or vertigo, are very common and can be due to minor conditions rather than stroke. But giving the information about recent neck manipulation can raise a red flag that you may have a cervical dissection rather than a less serious problem, particularly in the presence of neck pain."

Each year in the United States, there are approximately 795,000 new or recurrent strokes. About 88 percent of these strokes are ischemic (caused by blood clots), and about 15 percent of all ischemic strokes occur in young adults and adolescents. An estimated 532,000 to 852,000 persons aged 18 to 44 years in the U.S. have had a stroke. Cervical dissections are among the most frequent causes of ischemic stroke in adults under age 45, accounting for 8 percent to 25 percent of all cases. The overall prevalence is underestimated since a large number may not show symptoms.

Neck manipulation is widely used to treat a variety of musculoskeletal complaints, with nearly 85 percent involving adjustment or manipulation of the spine. With cervical manipulative therapy, a force is applied to the spine.

Typical movements for cervical manipulation can be rotation, lateral flexion, flexion, extension or a combination of these movements. Cervical dissection is most prevalent in the upper cervical spine and can involve the internal carotid artery or the vertebral artery. Cervical dissections associated with cervical manipulative therapy most often involve the vertebral arteries. Vertebral artery dissection is a major cause of posterior circulation ischemic stroke in young adults, and diagnosis can be challenging.

Diagnosis of cervical dissection depends on a thorough history, physical examination and targeted ancillary investigations. Recent minor trauma or sudden neck movements including neck manipulation or vigorous exercise are associated with arterial dissection. Patients with cervical dissection will frequently complain of headache or neck pain.

###

The writers of the American Heart Association/American Stroke Association Statement used the following sources to develop the Scientific Statement: systematic literature reviews; published clinical and epidemiology studies and morbidity and mortality reports; clinical and public health guidelines; personal files and expert opinion to summarize existing evidence.

Co-authors are Ralph L. Sacco, M.S., M.D., co-chair; Felipe C. Albuquerque, M.D.; Bart M. Demaerschalk, M.D., M.Sc.; Pierre Fayad, M.D.; Preston H. Long, D.C., Ph.D.; Lori D. Noorollah, M.D.; Peter D. Panagos, M.D.; Wouter I. Schievink, M.D.; Neil E. Schwartz, M.D. Ph.D.; Ashfaq Shuaib, M.D.; David E. Thaler, M.D., Ph.D.; and David L. Tirschwell, M.D., M.Sc., on behalf of the American Heart Association Stroke Council.

The scientific statement is endorsed by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

Jim Ritter | Eurek Alert!
Further information:
http://www.lumc.edu

Further reports about: Health blood cervical movements neck pain spine stroke symptoms therapy

More articles from Studies and Analyses:

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

nachricht Brain connectivity reveals hidden motives
04.03.2016 | Universität Zürich

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First experimental quantum simulation of particle physics phenomena

Physicists in Innsbruck have realized the first quantum simulation of lattice gauge theories, building a bridge between high-energy theory and atomic physics. In the journal Nature, Rainer Blatt‘s and Peter Zoller’s research teams describe how they simulated the creation of elementary particle pairs out of the vacuum by using a quantum computer.

Elementary particles are the fundamental buildings blocks of matter, and their properties are described by the Standard Model of particle physics. The...

Im Focus: Is There Life On Mars?

Survivalist back from Space - 18 months on the outer skin of the ISS

A year and a half on the outer wall of the International Space Station ISS in altitude of 400 kilometers is a real challenge. Whether a primordial bacterium...

Im Focus: CWRU physicists deploy magnetic vortex to control electron spin

Potential technology for quantum computing, keener sensors

Researchers at Case Western Reserve University have developed a way to swiftly and precisely control electron spins at room temperature.

Im Focus: Physicists measured something new in the radioactive decay of neutrons

The experiment inspired theorists; future ones could reveal new physics

A physics experiment performed at the National Institute of Standards and Technology (NIST) has enhanced scientists' understanding of how free neutrons decay...

Im Focus: Discovery of gold nanocluster 'double' hints at other shape changing particles

New analysis approach brings two unique atomic structures into focus

Chemically the same, graphite and diamonds are as physically distinct as two minerals can be, one opaque and soft, the other translucent and hard. What makes...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ERES 2016: The largest conference in the European real estate industry

09.06.2016 | Event News

Networking 4.0: International Laser Technology Congress AKL’16 Shows New Ways of Cooperations

24.05.2016 | Event News

Challenges of rural labor markets

20.05.2016 | Event News

 
Latest News

A shampoo bottle that empties completely -- every last drop

27.06.2016 | Innovative Products

Seeds of black holes could be revealed by gravitational waves detected in space

27.06.2016 | Physics and Astronomy

Neonicotinoid pesticides cause harm to honeybees

27.06.2016 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>