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 Some brain tumors may respond to immunotherapy, new study suggests
11.12.2018 | Columbia University Irving Medical Center

nachricht Climate change and air pollution damaging health and causing millions of premature deaths
30.11.2018 | International Institute for Applied Systems Analysis (IIASA)

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: Data use draining your battery? Tiny device to speed up memory while also saving power

The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.

Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...

Im Focus: An energy-efficient way to stay warm: Sew high-tech heating patches to your clothes

Personal patches could reduce energy waste in buildings, Rutgers-led study says

What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

Im Focus: Topological material switched off and on for the first time

Key advance for future topological transistors

Over the last decade, there has been much excitement about the discovery, recognised by the Nobel Prize in Physics only two years ago, that there are two types...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

Data use draining your battery? Tiny device to speed up memory while also saving power

14.12.2018 | Power and Electrical Engineering

Tangled magnetic fields power cosmic particle accelerators

14.12.2018 | Physics and Astronomy

In search of missing worlds, Hubble finds a fast evaporating exoplanet

14.12.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>