• Brown S

• Adult
• Causality
• Diagnostic Errors
• Female
• Informed Consent
• Manipulation, Spinal
• Stroke
• Vertebral Artery Dissection / diagnosis

In 2014, Mattox et al. published the case report Recognition of Spontaneous Vertebral Artery Dissection Preempting Spinal Manipulative Therapy: A Patient Presenting With Neck Pain and Headache for Chiropractic Care. Although this case report was published ten years ago, it is still referenced today as an example of chiropractic clinical competency. A critical analysis of this case report yields insights into the history, examination, differential diagnosis, and advanced imaging required to diagnose vertebral artery dissection (VAD).

This study is historically important as it was one of the first case reports of VAD published by the chiropractic profession. Other important early case reports of this nature were Kier (2006), Liebich (2014), Tarola (2015), and Futch (2015).

VAD and stroke were discussed in the literature as early as 1947.6–17 Notably, this topic has been discussed by chiropractic researchers: Haldeman (1999), Haldeman (2002), Tuchin (2013), and Brown (2024). The IFOMPT (International Federation of Orthopedic Manal Physical Therapists) Cervical Framework Document, a resource for examination of the cervical region for potential vascular pathology, was first published in 2012. Chaibi and Russell published a risk assessment strategy to exclude VAD in 2019.

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