BILATERAL TRAUMATIC INTERNAL CAROTID ARTERY DISSECTION ASSOCIATED WITH CHIROPRACTIC MANIPULATION : A CASE REPORT

Abstract

　　A 41-year-old women was admitted to our hospital for seizure. Brain CT revealed subarachnoid hemorrhage (SAH) and digital subtraction angiography demonstrated an aneurysm located in the left internal carotid artery, which was thought to be the cause of SAH. In addition, bilateral cervical internal carotid artery dissections (CICADs) were identified. Clipping of the aneurysm was carried out. CT at 1 day post-procedure demonstrated cerebral infarction. According to her detailed medical story, she had begun chiropractic care 27 days before admission. Chiropractic care was considered to have caused the bilateral CICADs, which in turn caused the thromboembolism and cerebral infarction. Antiplatelet therapy was administered, and she was transferred to the rehabilitation hospital 29 days after admission. MRA at 3 months post-procedure demonstrated improvement of bilateral CICADs.