Abstract：
UNASSIGNED: Chiropractic cervical spinal manipulations have several complications and can result in vascular injury, including traumatic dissection of the vertebral arteries. A 43-year-old woman was admitted to the emergency department after performing a self-chiropractic spinal manipulation. She experienced headache and vomiting and was unresponsive with severe hypertension at the time of hospital admission. Clinical computerized tomography angiography showed narrowing of the right vertebral artery but was inconclusive for dissection or thrombosis. At autopsy, subacute dissection of the right vertebral artery was identified along with cerebral edema and herniation. A small peripheral pulmonary thromboembolism in the right lung was also seen. Neuropathology consultation confirmed the presence of diffuse cerebral edema and acute hypoxic-ischemic changes, with multifocal acute subarachnoid and intraparenchymal hemorrhage of the brain and spinal cord. This case presents a unique circumstance of a fatal vertebral artery dissection after self-chiropractic manipulation that, to the best of our knowledge, has not been previously described in the medical literature.
摘要：
■颈椎整脊手法有多种并发症，可导致血管损伤，包括椎动脉的外伤性夹层.一名43岁的妇女在进行自我整脊脊柱操作后被送往急诊科。她出现头痛和呕吐，入院时对严重高血压无反应。临床计算机断层扫描血管造影显示右椎动脉狭窄，但对于夹层或血栓形成尚无定论。尸检时,发现右椎动脉亚急性夹层并伴有脑水肿和脑疝。在右肺也看到了一个小的外周肺血栓栓塞。神经病理学咨询证实存在弥漫性脑水肿和急性缺氧缺血性改变，多灶性急性蛛网膜下腔出血和脑和脊髓实质出血。此病例呈现了一种独特的情况，即在自我整脊操作后发生致命的椎动脉夹层，据我们所知,以前在医学文献中没有描述过。
