Thursday, July 14, 2022

Chiropractic manipulation and arterial dissection

 A recent college graduate in Georgia was reportedly left paralyzed after a routine chiropractor visit. 

Caitlin Jensen, 28, graduated from Georgia Southern University in May with a degree in chemistry and biology and went to an unnamed chiropractor on June 16 where she received a neck adjustment, according to a GoFundMe page dedicated to raising money for her medical expenses. 

But she was soon after rushed to an emergency room by ambulance, and tests revealed she had four dissected arteries in her neck, according to the page set up by Linda Foster. The damage caused her to go into cardiac arrest and suffer a stroke. She lost a pulse for 10 minutes before she was revived. 

"That morning we were up and talking to her before work. You're talking to her and then 30 minutes later, she's in the hospital and now in the ICU," Jensen’s brother, Caleb Johnson, told WJCL. 

After Jensen was stabilized, she was rushed into surgery, and doctors managed to repair some of the tears and placed a stent in one artery, according to the GoFundMe page. 

The woman’s mother, Darlene Jensen, told WSB-TV that her daughter’s doctors said the injury was a direct result of the neck adjustment and the family has retained legal counsel on her daughter’s behalf. 

"The surgeon that performed the surgery on her that saved her life, and every other doctor that has looked at her, have all agreed that this happened as a direct result of the neck manipulation," the elder Jensen said in the story published Tuesday. "The chiropractor called 911 and then called me and told me that she was ‘having a reaction to the treatment.’"

The chiropractor has not been named in local reports. WJCL reported reaching out to the chiropractor, who declined to comment on the incident and cited HIPAA privacy laws. 

Jensen remains hospitalized in critical condition at the neuro ICU in Memorial Hospital in Savannah, Georgia. She suffered a traumatic brain injury, according to the fundraising page, and is currently conscious and able to respond to verbal commands by blinking her eyes, as well as wiggling her the toes of her left foot. But the rest of her body sits in a state of paralysis due to the injury, the pages says. 

"She's able to open her eyes every now and then and wake up a little bit. And kind of move her hands to squeeze a little. But that's it," Johnson told WJLC for a story published Tuesday. 

As of Thursday morning, the GoFundMe page raised $56,676 of its $100,000 goal. Jensen’s family aims to have her transferred from the ICU to the Shepherd Center in Atlanta once she’s stable enough. 

"It's huge just to know that people are out there supporting as we to get her into therapy. She's just a young college student with not the best health care," Johnson said.

A site on Caring Bridge has also been established to provide updates on Jensen’s condition. The most recent update published Wednesday asked for prayers for Jensen, her family and medical staff, noting how Jensen had a "rough day" with mucus collecting in her lung, causing issues with her trachea tube. 

https://www.foxnews.com/us/georgia-college-graduate-left-paralyzed-routine-chiropractor-visit-neck-pain-goes-wrong

Jones J, Jones C, Nugent K. Vertebral artery dissection after a chiropractor neck manipulation. Proc (Bayl Univ Med Cent). 2015 Jan;28(1):88-90. doi: 10.1080/08998280.2015.11929202. PMID: 25552813; PMCID: PMC4264725

Abstract

The differential diagnosis for ischemic central nervous system infarcts in young patients includes paradoxic emboli through cardiac shunts, vasculitis, and vascular trauma. We report a young woman who developed headache, vomiting, diplopia, dizziness, and ataxia following neck manipulation by her chiropractor. A computed tomography scan of the head revealed an infarct in the inferior half of the left cerebellar hemisphere and compression of the fourth ventricle causing moderate acute obstructive hydrocephalus. Magnetic resonance angiography revealed severe narrowing and low flow in the intracranial segment of the left distal vertebral artery. The patient was treated with mannitol and a ventriculostomy and had an excellent functional recovery. This report illustrates the potential hazards associated with neck trauma, including chiropractic manipulation. The vertebral arteries are at risk for aneurysm formation and/or dissection, which can cause acute stroke.

Morton, A. Internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus. Chiropr Man Therap 20, 38 (2012). https://doi.org/10.1186/2045-709X-20-38

Abstract

A case of internal carotid artery dissection in a pregnant woman with Systemic Lupus Erythematosus (SLE) immediately following chiropractic treatment is presented. The literature regarding complications of neck manipulation during pregnancy, spontaneous dissection of craniocervical arteries in pregnancy and the postpartum period, and dissection of craniocervical arteries in SLE are reviewed. To the best of the author’s knowledge, this is the first case of carotid artery dissection following chiropractic treatment in a pregnant woman published in the literature.


Turner CR (2018) The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature. Biomed Res Rev 2: DOI: 10.15761/BRR.1000110


Abstract

Chiropractic cervical manipulation is a common practice utilized around the world. Most patients are never cleared medically for manipulation, which can be devastating for those few who are at increased risk for dissections. The high velocity thrust used in cervical manipulation can produce significant strain on carotid and vertebral vessels. Once a dissection has occurred, the risk of thrombus formation, ischemic stroke, paralysis, and even death is drastically increased. In this case report, we highlight a case of a 32-year-old woman who underwent chiropractic manipulation and had vertebral artery dissection with subsequent brainstem infarct. She quickly deteriorated and passed away shortly after arrival to the hospital. Although rare, one in 48 chiropractors have experienced such an event. We utilize this case to highlight the risk associated with cervical manipulation and urge open dialogue between chiropractors and physicians. Receiving medical clearance prior to cervical manipulation in potential at risk patients would drastically reduce morbidity and mortality. 

See: https://childnervoussystem.blogspot.com/2016/05/chiropractic-care-and-cervical-artery.html

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