Stroke after neck treatment? A clarifying overview

Veröffentlicht:

Von:

Interessante Review zeigt: Sofortige Schlaganfälle durch HWS-Manipulation resultieren eher aus vorbestehenden Dissektionen, nicht daraus selbst. Wichtig für die Praxis!
Interesting review shows that immediate strokes from HWS manipulation result from pre-existing dissections, not from it. Important for practice! (Symbolbild/natur.wiki)

In a recently conducted study published in March 2024, researchers examined the possible relationships between manipulation of the cervical spine (known as CSM) and the immediate development of strokes. CSM is a treatment technique that is often used by chiropracticians to relieve pain and tensions in the neck area. There was concern that this treatment could lead to dissections in healthy neck arteries, which in the worst case could result in an immediate stroke.

However, the investigation comes to the conclusion that there is no causal connection between CSM and the dissection of the neck arteries (CAD) in healthy neck arteries. Instead, research identified plausible thromboembolic and thrombotic mechanisms through which an immediate stroke according to CSM could occur. One crucial point here is that these mechanisms require that a CAD is already present before the CSM is carried out, and not that the CAD is created as a result of the CSM.

These findings could have far -reaching effects on practice and medical law aspects for doctors who carry out CSM. They underline the need for a thorough medical examination and diagnosis before CSM treatment in order to identify any pre-existing CAD and thus minimize the risk of an immediate stroke.

These research results could lead to doctors change their practices to ensure that patients are assessed correctly before they are subjected to CSM treatment. It could also promote the development of new guidelines and training courses for risk assessment before CSM.

basic terms and concepts:

  • CSM (Cervical Spine Manipulation): A treatment method in which manual techniques put pressure on the cervical spine to relieve pain and improve mobility.
  • CAD (Cervical Artery Dissection): A disease in which there is a crack in the walls of a neck artery, which leads to bleeding into the artery wall and increases the risk of stroke.
  • thromboembolic and thrombotic: reference to the formation of a blood clot within a blood vessel that potentially block a vessel (thrombotic) or can loosen it and cause blockages in another part of the body (thromboembolic).
  • stroke: A medical emergency in which blood supply is interrupted to part of the brain, which leads to a death of brain cells.

These research results suggest that the secure use of CSM requires a precise assessment of a patient's health, especially with regard to the nervous arteries in order to reduce the risk of immediate stroke.

plausible mechanisms for immediate stroke after cervical manipulation

The debate about the safety of manipulation of the cervical spine (CSM) and the risk of an immediate instant stroke resulting continues. In particular, the question arises whether CSM can cause a dissection of healthy cervical arteries and lead to an immediate stroke. However, the current research refutes a causal connection between CSM and cervical artery disease (CAD) in healthy cervical arteries. This study goal was to check the literature as to whether plausible mechanisms can be identified by CSM for causing an immediate stroke, an immediate stroke is defined as a stroke that occurs within seconds or minutes after a CSM.

The review resulted in plausible thrombboembolic and thrombotic mechanisms that could cause an immediate stroke by CSM. A recurring aspect of these mechanisms is that a CAD is already present before the implementation of a CSM and does not arise as a result of a CSM. This statement offers a significant insight into the discussion by pointing out that the actual danger may exist before manipulation even takes place.

The identification of these mechanisms has both clinical and medical law implications for doctors who carry out CSM. It emphasizes the importance of a careful patient history and examination in order to exclude existing risk factors or previous illnesses that could lead to a CAD. In addition, it underlines the need for adequate information about potential risks.

It is important to note that current research emphasizes the need for further studies on the specific risk factors and the frequency, with the CSM to a CAD or an immediate stroke. A stronger focus on precise diagnostic procedures for the identification of vulnerable patient groups could lead to a safer practice of the CSM.

For further details we refer to the full study at https://pubmed.nlm.nih.gov/38510520 .