Complications of Cervical Manipulation: A Case Report of Fatal Brainstem Infarct with Review of the Mechanisms and Predisposing Factors
Jentzen, JM
Formerly, assistant medical examiner, Hennepin County, Minneapolis, MN; now, medical exam-iner, Milwaukee County, Milwaukee, WI.

Amatuzio, J
Assistant coroner, Scott and Dakota Counties, Hastings, MN.

Peterson, GF
Medical examiner, Hennepin County, Minneapolis, MN.


Abstract
Medical and surgical complications of chiropractic manipulation occur infrequently in relation to the number of procedures performed. These complications include intracranial hemorrhage, spinal cord injuries, trauma to the carotid and vertebral arteries, and vertebral-basilar distribution infarction. This is a report of a case of vertebrobasilar infarction following chiropractic manipulation leading to a comatose state within 1 h following the manipulative procedure. This case report should alert the forensic pathologist to the possibility of cervical manipulation as a cause of acute brainstem infarction, and the mechanism and the predisposing factors to injury should be reviewed. The importance of careful autopsy technique and use of postmortem arteriographic techniques are emphasized.

Keywords:
brain, central nervous system, chiropractic, forensic science, pathology and biology

Paper ID: JFS324871089

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Author Jentzen JM, Amatuzio J, Peterson GF Title Complications of Cervical Manipulation: A Case Report of Fatal Brainstem Infarct with Review of the Mechanisms and Predisposing Factors Symposium , Committee on