Case Report
 
Lateral medullary syndrome post-chiropractic manipulation in a 25-year old female with headache
Matthew Kynan Burrage1, Clare Therese Costello2
1MBBS, House Officer, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
2MBBS, House Officer, Ipswich General Hospital, Brisbane, Queensland, Australia.

doi:10.5348/ijcri-201460-CR-10371

Address correspondence to:
Matthew Kynan Burrage
Princess Alexandra Hospital
199 Ipswich Road
Woolloongabba, Brisbane Queensland
AUSTRALIA 4102
Phone: +61 (07) 3176 2111
Email: mkburrage@gmail.com

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How to cite this article
Burrage MK, Costello CT. Lateral medullary syndrome post-chiropractic manipulation in a 25-year old female with headache. International Journal of Case Reports and Images 2014;5(4):295–298.


Abstract
Introduction: Cervical chiropractic manipulation for the treatment of back and neck pain is becoming increasingly commonplace, especially amongst younger adults. It may also give rise to serious complications, such as dissection of cervical arteries with resultant stroke syndromes. This case report reviews the literature surrounding this issue and highlights the importance of correctly diagnosing cerebrovascular pathology in young adults.
Case Report: We describe a case of a 25-year-old female with delayed onset of focal neurology and lateral medullary syndrome post-chiropractic cervical manipulation. Magnetic resonance angiogram and computed tomography angiogram confirm lateral medullary infarction and bilateral vertebral artery dissection.
Conclusion: Currently, chiropractic manipulation and complications are a relatively topical issue and some of the potential serious complications are discussed in this case. Certain posterior circulation stroke symptoms belong to distinct clinical syndromes and it is important to be aware of these when assessing patients with possible posterior circulation ischemia. This is especially important in younger populations, where misdiagnosis as migraine may be a common pitfall. Headache and focal neurology following chiropractic cervical manipulation should be managed and investigated with a high index of suspicion for vertebral artery dissection.

Keywords: Lateral medullary syndrome, Chiropractor, Vertebral dissection


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Author Contributions
Matthew Kynan Burrage – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Clare Therese Costello – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© Matthew Kynan Burrage et al. 2014; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)



About The Authors

Matthew Burrage is a Medical Registrar undergoing basic physician training at the Princess Alexandra Hospital in Brisbane, Australia. He has a strong interest in Cardiology.



Clare Costello is a Medical Registrar undergoing basic physician training at the Mater Adults Hospital in Brisbane Australia. She has a broad interest in General medicine.