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.
Highlights
Dissection of the internal carotid artery accounts for approximately 20% of cases of ischaemic stroke in young adults
It remains unclear as to whether chiropractic neck manipulation is associated with craniocervical artery dissection
This paper describes a case of internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus
Summary
Dissection of the internal carotid artery accounts for approximately 20% of cases of ischaemic stroke in young adults. It remains unclear as to whether chiropractic neck manipulation is associated with craniocervical artery dissection. This paper describes a case of internal carotid artery dissection following chiropractic treatment in a pregnant woman with Systemic Lupus Erythematosus. Case presentation A thirty-one year old woman, pregnant at 16 weeks gestation, presented to a chiropractor for treatment of occipital headache. She had suffered with intermittent bilateral occipital muscle tension headaches occurring. After receiving treatment the subject noted severe right sided anterior neck pain, and rapidly developed ipsilateral Horner’s syndrome. Follow-up MRI six months later revealed a focal false aneurysm of the right internal carotid artery. The Horner’s syndrome persists one year after the initial presentation
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