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					   September 2003



           SIGNIFICANCE OF PUBLISHED STUDIES AND CASE REPORTS

HIGHEST NECK MANIPULATION

        OCCIPUT TO CERVICAL ONE (ATLAS) AND CERVICAL ONE TO
                       CERVICAL TWO (AXIS)



Research of an issue of health care concern often begins with a search of a medical
database. This can now be done via the public internet from available free databases or
through more sophisticated research programs.



What do we learn from such a search? Published reports in the scientific literature allow
us to stand on the very tip of the iceberg largely unaware of the reality below. Most
scientists never take the time and effort required to report what they have found. Medical
Journals refuse the great majority of submissions. Thus the overall picture of the true
incidence and seriousness of an issue is simply reflected by the medical database
resource.



Yet the scientific literature does provide some insights. How many well respected
scientific journals have addressed the issue? How consistent year in and year out have
reports been made? How many different countries have reported on the issue? What is the
degree of specialization of those scientists publishing these studies? What is the range of
problems reported?



In regard to the issue of highest neck manipulation, occipital to cervical one (atlas
vertebrae) and cervical one to cervical two (axis vertebrae) studies have been reported in
numerous scientific journals including, The Journal of Forensic Science, The Journal of
Clinical Pathology, The Journal of the American Medical Association, the Journal of the
Canadian Medical Association, the British Medical Journal, the journals “Neurology:
“Stroke”, “Lancet”, “Pediatrics”, The new England Journal of Medicine, The American
Journal of Emergency Medicine, etc. etc.
The range of interest of these Journals include neurology, neuroradiology, pathology,
forensic sciences, legal publications, family medicine, rehabilitation medicine,
ophthalmology, audiology etc. etc. Numerous prestigious hospitals and Universities
across the world have reported cases including the Mayo Clinic, Johns Hopkins Hospital,
the Claude Bernard Hospital, the Veterans Administration Medical center in California,
etc. etc.



The issue has been reported from Canada, the United States, Denmark, Germany, Italy,
Australia, Japan, England, Canada, China, South Africa, Ireland, New Zealand,
Switzerland, etc. etc. indeed worldwide.



The issue has also been reported on since the very inception of modern medical index
medicus over 60 years ago. The quality of the reports, moving from observations and
commentaries, case reports to retrospective analysis and statistical studies has been
consistent.



The medical consequences of neck manipulation run the range from simple spells of
nausea to the Locked-In Syndrome to death. It happens in all ages, from babies to people
in their 80’s. It most commonly happens in young adults in the prime of their lives. The
wide range of neurological and pathological findings in the countless cases reported can
make a pathologist shudder. The posterior circulation supplies the very “stem” of our
neurological system and any tampering with it must be done as an absolute last resort.



The neuro-pathological findings run the range of little or no findings to those showing
clear adventitial dissection and indeed rupture of the entire artery. As stated by
neurologist Wouter I. Schievink M.D. “Intimal tears are notoriously difficult to identify
at the time of microscopic examination of postmortem or surgical specimens”. (NEJM
Vol. 344. No.12).



 A) Compression and/or stretching leading to subintimal hematoma. The fenestrations of
the intima unfold and may become scarred or even tear.



B) A simple intimal tear leading to an endothelial reaction. This can lead to a cascade of
thrombus and embolus.
C) An intimal tear with a thrombus that restricts the lumen.



D) Vessel wall dissection, the most common type though by many to be between the
endothelial layer and the internal elastica lamina.



E) Vessel wall dissection with psuedo-anurysm. The muscularis as well as the intima and
internal elastic lamina are disrupted.



F) Perivascular bleeding. Sub-arachnoid hemorrhage may be fatal.



THE TIP OF THE ICEBERG




YEAR          REFERENCE                        DETAILS                      COMMENT
400 B.C.      Hippocrates                      Neck manipulation may        Problems due to neck
                                               make “much mischief.”        manipulation have been
                                                                            known for over 2000 years.
1867          Paget, James.                     “Chaos of this kind is of   Problems reported by
                                               frequent occurrence.”        bonesetters over 125 years
              “Bone-setter”“ Cases that                                     ago.
              Bone-setters cure”
1934          Foster versus Thornton.   Practitioner:                       DEATH two weeks later.
                                        Chiropractor.
              Malpractice.
                                        Patient: female patient.
              J.A.M.A.
              1934:103(16):1260         Cerebral hemorrhage.
1935          Foster versus Thornton.   Treated for headaches.              As above.

              Malpractice.                     Comment on above.

              J.A.M.A.1935:105(21):1714.
1937   Foster versus Thornton.        Treated for headache.      As above.

       Malpractice.                   Comment on above.

       J.A.M.A.1937: 109 (3): 233-
       4.




1947   Pratt-Thomas HR, Berger        Practitioner:              DEATH 24 hours after neck
       KE. J.A.M.A. 1947; 133         Chiropractor.              manipulation
       (9):600-3.
                                      Male patient. 34 years.

                                      Thrombosis of posterior
                                      inferior cerebellar
                                      arteries.
1952   Bakewell v Kahle..             Practitioner:              BRAIN DAMAGE.
                                      Chiropractor.
       J.A.M.A. 1952; 148 (8): 699.                              Vertebral-basilar infarction.
                                      Patient: female patient.

                                      Rupture of brain tumor.
1952   Ford FR.                       Practitioner:              BRAINSTEM DAMAGE
                                      Chiropractor.
       Bulletin. Johns Hopkins
       Hospital. 1952;91:168-73       Dizzy spells, visual
                                      disturbances

1952   Kunkle EC, Muller JC.          Practitioner:              BRAINSTEM.
                                      Chiropractor.
       Ann Int Med 1952;36:1329-                                 WALLANBERG
       35                             Male patient age 35.       SYNDROME.

                                      Vascular thrombosis.
1955   York v. Daniels.               Practitioner:              DEATH 18 hours after neck
                                      Chiropractor.              manipulation.
       J.A.M.A. 1955; 159 (8):809.
                                      Patient: female patient.

                                      Compression of the
                                      spinal cord due to
                                      bleeding.
1956   Ford FR, Clark D.             Wife.                        DEATH 3 days after neck
                                                                  manipulation.
       Bulletin. Johns Hopkins       Male patient age 37
       Hospital: 1956; 98: 37-42.
                                     Thrombosis posterior-
                                     inferior cerebellar artery
                                     and left posterior
                                     cerebral.
1956   Ford FR, Clark D.             Practitioner:                WALLENBERG
                                     Chiropractor.                SYNDROME
       Bulletin Johns Hopkins
       Hospital 1956; 98: 37-42.     Male patient. Age 41.


1956   Ford FR, Clark D.             Practitioner:                DEATH
                                     Chiropractor.
       Bulletin Johns Hopkins
       Hospital 1956; 98: 37-42.     Basilar artery
                                     thrombosis.

1956   Schwarz GA, Geiger JK,        Practitioner:                WALLENBERG
                                     Chiropractor.                SYNDROME
       Arch Intern Med 1956; 97: 3
       524.                          Patient: female patient
                                     age 28.

                                     Posterior inferior
                                     cerebellar artery
                                     thrombosis

YEAR   REFERENCE                     DETAILS                      COMMENT
1957   Attali P.                     Practitioner:                BARRE-LIEOU
                                     Chiropractor                 SYNDROME
       Accidents graves apres une
       manipulation intempestive     Patient: female patient
       par un chiropractor.          age 43

       Rev Rheum 1957; 24: 652.
1957   Boudin G. Barbizet J.         Practitioner:                BRAINSTEM DAMAGE
                                     Chiropractor
       Bulletin Mem Soc Med Hop
       Paris 1957;73:526-6           Patient: female patient
                                     32 years

                                     Syndrome grave do tronc
                                     cerebral apres
                                     manipulations cervicales.
1959   Green D Joynt RJ              Practitioner:             BRAINSTEM
                                     Chiropractor.
       J.A.M.A. 1959; 170 (5):522-
       4                             Patient: female patient
                                     age 31.

                                     Vascular accidents to the
                                     brain stem associated
                                     with neck manipulations.
1959   Green D Joynt RJ              Practitioner:               BRAINSTEM
                                     Chiropractor
       J.A.M.A. 1959; 170 (5):522-
       4                             Male patient age 55

                                     Vascular accidents to the
                                     brain stem associated
                                     with neck manipulations.
1959   Boshes LD.                    Practitioner:               Upper arm paralysis, slurred
                                     Chiropractor                speech, visual defects.
       J.A.M.A. 1959; 171: 1602.
                                     Patient: female age 24

                                     Vascular accidents
                                     associated with neck
                                     manipulation.
1959   Boshes LD.                    Practitioner:               Slurred speech, visual defects.
                                     Chiropractor.
       J.A.M.A. 1959; 171: 1602.
                                     Patient: female patient.
                                     Mother of the above
                                     patient.
1959   Boshes LD.                    Practitioner:               Slurred speech, visual defects.
                                     Chiropractor
       J.A.M.A. 1959; 171: 1602.
                                     Male patient. Father of
                                     the above patient.
1960   Bouchet MM. Pailler P.        Practitioner:               DEAFNESS
                                     Chiropractor.
       Surdite brutale et
             chiropractic.           Patient: female.

       Ann Otolarvngol (Paris)
       1,060; 77:951-3.
1960   Hardin CA, Williamson P,      Physician.                  Speech defects, sweating spell,
                                                                 fainting spells.
       Steegman A.                    Male patient. Age 50

       Neurolgy. 1960; 10: 855-8.     Vertebral artery
                                      insufficiency produced
                                      by cervical osteoarthritic
                                      spurs.
1960   Martin H, Guiral J.            Practitioner:                Deafness and ringing in the
                                      Chiropractor.                ears.
       France O.R.L. 1960:9: 177-8.
                                      Male patient. Age 40.
       (Ear, Nose, Throat)
                                      Surdite brusque au cours
                                      d'une

                                      Manipulation vertebrates
1962   Masson M, Cambier.             Muscle therapist.            WALLENBERG
                                                                   SYNDROME
       Presse Medicale.               Patient: female patient.
       1962;70(43):1990-3             Age 33
1962   Smith RA. Estridge MN.         Practitioner:                DEATH 3 days after neck
                                      Chiropractor                 manipulation. Cerebellar and
       J.A.M.A.1962; 182(5):528-                                   brainstem damage.
       31                             Patient: female patient
                                      age 33.

                                      Neurological
                                      complications of head
                                      and neck manipulations.
1963   Pribek RA.                     Practitioner:                BRAINSTEM DAMAGE
                                      Chiropractor.
       Wisc Med J 1963;62(3):141-
       3                              Male patient age 63

                                      Brainstem vascular
                                      accident following neck
                                      manipulation.
YEAR   REFERENCE                      DETAILS                      COMMENT
1963   Roche L, Collin M, De          Physician                    DEATH 2 days after neck
       rougemont J,                                                manipulation.
                                      Sex and age of patient
       Ann Med Leg 1963; 43: 232-     not reported.
       5
                                      Traumatic lesions to the
                                      vertebral artery.
1963   Brain L,                       Practitioner: Unknown.       PARTIAL VISUAL LOSS
       British Med Journal            Patient: female patient.
                                      Age 68
       1963; 1 (Mar 23): 771-7
                                      Neck traction caused
                                      visual loss.


1965   Godlewski S.                   Practitioner:              QUADRIPLEGIA
                                      Chiropractor.
       Assises Med 1965; 23
       (2):81-92                      Patient: female. Age 66

                                      Diagnostic des
                                      thromboses vertebro-
                                      basilaire.


1966   Janzen-Hamburg R. Arch         Practitioner:              WALLENBERG
       Klin Chir 1966; 316-461-9      Chiropractor               SYNDROME

                                      Sex and age unknown.
                                      Schleudertrauma der
                                      Halseirbelsaule,
                                      neurologische

                                      probleme. Langenbecks
1967   Nick J, Contamin F, Nicolle    Practitioner:              DOUBLE VISION.
       MH.                            Chiropractor

       Bulletin. Mem Soc Med          Patient: female. Age 48
       Hop Paris 1967: 118 (5): 435
       40                             Incidents et acidents

                                      neurologiques dus aux
                                      manipulations
                                      cervicales: A propos de
                                      trois observations.
1967   Nick J, Contamin F, Nicolle    Practitioner: Unknown.     DOUBLE VISION. DIZZY
       MH.                                                       SPELLS.
                                      Patient: female age 60.
       Bulletin. Mem Soc Med
       Hop Paris 1967: 118 (5): 435   Neurological accidents
       40                             following neck
                                      manipulation.
1971   Heyden S.                     Practitioner:               MIXTURE OF
                                     Chiropractor.               NEUROLOGICAL
       Mat Med Nordm 1971; 23:                                   DEFICITS.
       24-32.                        Patient: female age 29.

                                     Vertebral artery
                                     thrombosis.


1971   Wood MJ, Lang EK, Faludi      Practitioner:               MIXTURE OF
       HK, Woolhandler GJ. J         Chiropractor                NEUROLOGICAL
       Louisiana Med Soc 1971;                                   DEFICITS.
       123 (12): 413-4.              Male age 34

                                     Traumatic vertebral

                                     artery thrombosis.
1972   Kanshepolsky J, Danielson     Practitioner:               INFARCTION OF RIGHT
       H, Flynn RE. Bull LA          Chiropractor                CEREBULLUM.
       Neurol Soc
                                     Patient: female age 39
       1972;37: 62-6.
                                     Vertebral artery
                                     insufficiency

                                     and cerebellar infarction
                                     due to manipulation of
                                     the neck.
1972   Lorenz R, Vogelsang HG.       Practitioner:               DEATH. 58 days after neck
       Deutsche Med                  Chiropractor.               manipulation.

       Wochenschrift 1972; 97: 36-   Patient: female age 39
       43.
                                     Basilar artery thrombosis
                                     following chiropractic
                                     neck manipulation.
1973   Kommerell G, Hoyt WF.         Practitioner:               VISUAL EYE MOTOR
       Arch                          Chiropractor.               LOSS. LEFT WALLENBERG
                                                                 SYNDROME.
       Neurol 1973; 28: 313-8.       Patient: female age 52.

                                     Lateropulsion of
                                     saccadic eye movements.
YEAR   REFERENCE                     DETAILS                    COMMENT
1973   Nagler W.                     Practitioner: Unknown.     TOTAL LIMB SPASTICITY.
                                                                NEEDS A WALKER.
       Arch Phys Med Rehab 1973;     Male age 55
       54: 237-40.
                                     Vertebral artery
                                     obstruction by
                                     hyperextension of the
                                     neck;

                                     Report of three cases.
1973   Schmitt HP, Tamaska L. Z      Naturopath.                DEATH 3 HOURS AFTER
       Rechtsmedizin 1973; 73:                                  NECK MANIPULATION.
                                     Patient: female age 35.
       301-8.                        Vertebral and basilar
                                     artery rupture.
1974   Kramer KH, Wallenburg         Practitioner: Physician.   WALLENBERG
       Manuelle Medizin 1974; 2:                                SYNDROME
       121-4.                        Patient: female age 35.

                                     Thrombosis of the right
                                     vertebral artery.
1974   Lyness SS. Wagman AD.         Osteopath.                 LOCKED IN SYNDROME.
                                                                TETRAPLEGIC.
       Surg Neurol 1974; 2: 121-4.   Patient: female age 20.

                                     Neurological deficit
                                     following cervical
                                     manipulation.
1974   Mehalic T. Farhat SM. Surg    Practitioner:              SLOW SPEECH.
       Neuro 1974; 2: 125-9.         Chiropractor.              UNSTEADY GAIT. EYE
                                                                NYSTAGMUS.
                                     Male age 40.

                                     Vertebral artery injury
                                     from chiropractic

                                     Manipulation of the
                                     neck.
1974   Mehalic T. Farhat SM. Surg    Practitioner:              ATAXIA. SLOW SPEECH.
                                                                NYSTAGMUS OF EYES.
       Neuro 1974; 2: 125-9.         Chiropractor.

                                     Male age 30.

                                     Vertebral artery trauma.
1974   Kosoy J, Glassman AL.         Practitioner: Physician.    BRAINSTEM STROKE.

       Tex Med 1974; 70: 66-71.      Male age 36

                                     Audiovestibular findings
                                     with cervical spine
                                     trauma.
1974   Miller RG, Burton R.          Practitioner:               WALLENBERG
                                     Chiropractor.               SYNDROME
       J.A.M.A. 1974; 229 (2): 189-
       90.                          Patient: female age 52.

                                     Stroke following
                                     chiropractic
                                     manipulation of the

                                     spine.
1974   Miller RG, Burton R.          Practitioner:               SEVERE HANDICAP.
                                     Chiropractor                INTELLECTUAL DEFICITS.
       J.A.M.A. 1974; 229 (2): 189-                              VISUAL DEFECTS.
       90.                          Male age 53

                                     Thrombosis of the
                                     cerebral artery.
1975   Bladin PF, Merory J..         Practitioner:               MINOR DEFICITS AFTER
                                     Chiropractor.               TREATMENT.
       Proc Aust Assoc Neuro
       1975; 12:35-41.               Patient: female age 31

                                     Mechanisms in cerebral
                                     lesions in trauma to high

                                     cervical portion of the
                                     vertebral artery rotation
                                     injury
1975   Davidson KC, Weiford EC,      Practitioner:               HEARING LOSS. FACIAL
       Dixon GD. Radiology 1975;     Chiropractor.               PARESIS.
       115:
                                     Patient: female age 42
       651-2.
                                     Traumatic vertebral
                                     artery

                                     Pseudoaneurysm
                                     following chiropractic
                                     manipulation.
1975   Kipp W. Todlicher Eberhard    Practitioner: Unknown.      DEATH 3 days after neck
       Karls Universtitaet 1975;                                 manipulation.
       :39.                          Patient: female age 34

                                     Hirnstamminfarkt nach
                                     HWS-Manipulation

                                     (Dissertation).
                                     Tubingen:

YEAR   REFERENCE                     DETAILS                     COMMENT
1976   Goodbody RA.                  Osteopath.                  DEATH 2 days after neck
                                                                 manipulation.
       J Clin Pathol 1976; 29 (1):   Male age 23
       86-7.
                                     Fatal post-traumatic
                                     vertebrobasilar ischemia.
1976   Hensell V.                    Practitioner: Physician.    DEATH 24 hours after neck
                                                                 manipulation.
       Med Welt 1976; 27 (14):       Patient: female age 52
       656-8.
                                     Neurologische Schaden
                                     nach Repositions
                                     massnahmen an der

                                     Wirbelsaule.
1976   Mueller S, Sahs AL.           Practitioner: Unknown       RECOVERED AFTER
                                                                 MINOR DEFICITS.
       Neurology (Minneapolis)       Patient: female age 43
       1976; 26: 547-60.
                                     Brain stem dysfunction
                                     related to cervical

                                     Manipulation.
1976   Mueller S, Sahs AL.           Practitioner: Unknown.      ASSORTED
                                                                 NEUROLOGICAL
       Neurology (Minneapolis)       Patient: female age 28.     DEFECTS.
       1976; 26: 547-60.
                                     Anterior dislocation of
                                     C-2.
1976   Mueller S, Sahs AL.          Practitioner: Unknown.        RESIDUAL DYSTAXIA
                                                                  AND DYSARTHRIA AND
       Neurology (Minneapolis)      Male age 38                   HEADACHES.
       1976; 26: 547-60.
                                    Posterior inferior
                                    cerebellar artery
                                    thrombosis.
1976   Schmitt HP.                  Practitioner: Physician.      DEATH 4 weeks after neck
                                                                  manipulation.
       Schweizer Archiv fur         Male age 51
       Neurologie Neurochirurgie
       und Psychiatrie 1976; 119:   Left vertebral artery
       363-9.                       thrombosis.
1977   Beatty RA.                   Practitioner:                 NO DEFICITS AFTER
                                    Chiropractor.                 SURGERY.
       Journal of Trauma 1977; 17
       (3): 248-9.                  Male age 37

                                    Dissecting hematoma of
                                    the internal carotid artery

                                    following chiropractic
                                    cervical manipulation.
1977   Easton JK, Sherman DG.       Practitioner:                 ATAXIA. DYSARTHRIA.
       Stroke 1977;                 Chiropractor.

       8 (5): 594-7.                Patient: female age 48

                                    Cervical manipulation
                                    and stroke.
1977   Easton JK, Sherman DG.       Practitioner:                 WALLENBERG
                                    Chiropractor                  SYNDROME.
       Stroke 1977;
                                    Patient: female age 44.
       8 (5): 594-7.
                                    Cervical manipulation
                                    and stroke.
1977   Zauel D, Carlow T            Practitioner:                 FACIAL HEMIPARESIS.
                                    Chiropractor.                 VISUAL DEFICITS.
       Journal Ann Neurology
       1977; 1 (3): 308.            Patient: female age 47.

                                    Internuclear
                                    ophthalmoplegia
                                    following cervical
                                        Manipulation.
1978   Gorman RF.                       Practitioner: Physician.    RECOVERED

       Med J Aust                       Male age 38.

       1978;2: 169-70.                  Cardiac arrest after
                                        cervical spine
                                        mobilization
1978   Nyberg-Hanser R, Loken           Practitioner: Physician     DEATH after five years in a
       AC, Tenstad O.                                               coma.
                                        Patient: female age 38
       Journal Neurolgy 1978; 218:
       97-105.                     Brainstem lesion with
                                   coma for five years
                                   following manipulation
                                   of the cervical spine.


YEAR   REFERENCE                        DETAILS                     COMMENT
1978   Parkin PJ, Wallis WE,            Practitioner:               BABINSKI-NAGORETTE
       Wilson JL. NZ Med J 1978;        Physiotherapist.            SYNDROME.
       88: 441-3.
                                        Patient: female age 23

                                        Left vertebral artery
                                        occlusion following

                                        Manipulation of the
                                        neck.
1978   Zimmermann AW, Kumar             Practitioner:               WALLENBERG
       AJ, Gadoth N, Hodges FJ.         Chiropractor                SYNDROME
       Neurology 1978; 28: 185-8.
                                        Male age 7                  Note: Symptoms of brainstem
       Pediatric case.                                              ischaemia persisted for four
                                        Traumatic                   months before culminating in
                                                                    cerebellar infarction.
                                        vertebrobasilar occlusive
                                        disease in childhood.
1980   Krueger BR, Okazaki H.           Practitioner:               STROKE
       Mayo Clinic                      Chiropractor.
       Proceedings.55:322-232.
       1980.                            Sex unknown. Age 31-
                                        35
       Vertebral-basilar distribution
       infarction following             Vertebral artery.
       chiropractic cervical
       manipulation.


1980   Krueger BR, Okazaki H.           Practitioner:           STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Sex unknown Age 36-40

       Vertebral-basilar distribution   Vertebral artery.
       infarction following
       chiropractic cervical
       manipulation.
1980   Krueger BR, Okazaki H.           Practitioner:           STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Sex unknown Age 36-40

       Vertebral-basilar distribution   Vertebral artery.
       infarction following
       chiropractic cervical
       manipulation.


1980   Krueger BR, Okazaki H.           Practitioner:           STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Sex unknown Age 41-45

       Vertebral-basilar distribution   Vertebral artery
       infarction following
       chiropractic cervical
       manipulation.


1980   Krueger BR, Okazaki H.           Practitioner:           STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Sex unknown Age 41-45

       Vertebral-basilar distribution   Vertebral artery.
       infarction following
       chiropractic cervical
       manipulation.


1980   Krueger BR, Okazaki H.           Practitioner:           STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Sex unknown Age 46-50

       Vertebral-basilar distribution   Vertebral artery.
       infarction following
       chiropractic cervical
       manipulation.
1980   Krueger BR, Okazaki H.           Practitioner:              STROKE
       Mayo Clinic                      Chiropractor
       Proceedings.55:322-232.
       1980                             Patient: female Age 29

       Vertebral-basilar distribution   Vertebro-basilar.
       infarction following
       chiropractic cervical
       manipulation.
1980   Krueger BR, Okazaki H.           Practitioner:              DEATH 2 days after neck
       Mayo Clinic                      Chiropractor               manipulation.
       Proceedings.55:322-232.
       1980                             Male age 25

       Vertebral-basilar distribution   Cerebellar and brainstem
       infarction following             infarction due to
       chiropractic cervical            vertebral and basilar
       manipulation.                    artery thrombosis.
1980   Krueger BR, Okazaki H.           Practitioner:              BILATERAL
       Mayo Clinic                      Chiropractor               HEMIANOPSIA.
       Proceedings.55:322-232.
       1980                             Patient: female Age 39

       Vertebral-basilar distribution   vertebrobasilar
       infarction following             infarction.
       chiropractic cervical
       manipulation.
1980   Krueger BR, Okazaki H.           Practitioner:              STROKE. MEMORY
       Mayo Clinic                      Chiropractor               DEFICITS.
       Proceedings.55:322-232.
       1980                             Male age 53.

       Vertebral-basilar distribution   Bilateral posterior
       infarction following             cerebral artery
       chiropractic cervical            obstruction.
       manipulation.
1980   Krueger BR, Okazaki H.           Practitioner: Unknown      MILD NEUROLOGICAL
       Mayo Clinic                                                 SIGNS/
       Proceedings.55:322-232.          Patient: female age 56
       1980
                                        vertebro-basilar
       Vertebral-basilar distribution   insufficiency.
       infarction following
       chiropractic cervical
       manipulation.
1980   Schellhas KP, Latchaw RE,        Practitioner:               SPASATIC
       Wendling LR, Gold LHA.           Chiropractor                QUADRIPLEGIA. LOCK-IN
                                                                    SYNDROME.
       Vertebrobasilar                  Patient: female 36.

       injuries following cervical      Basilar artery occlusion.
       manipulation.

       J.A.M.A. 1980; 244 (13):

       1450-3.


1980   Schellhas KP, Latchaw RE,        Practitioner:               WALLANBERG
       Wendling LR, Gold LHA.           Chiropractor                SYNDROME.

       Vertebrobasilar                  Patient: female 31

       injuries following cervical      Vertebrobasilar
       manipulation.
                                        Injuries following
       J.A.M.A. 1980; 244 (13):         cervical manipulation.

       1450-3.


1980   Schellhas KP, Latchaw RE,        Practitioner:               WALLENBERG
       Wendling LR, Gold LHA.           Chiropractor                SYNDROME.

       Vertebrobasilar                  Patient: female 32

       injuries following cervical      Vertebrobasilar
       manipulation.
                                        Injuries following
       J.A.M.A. 1980; 244 (13):         cervical manipulation.

       1450-3.
YEAR   REFERENCE                       DETAILS                     COMMENT
1980   Schellhas KP, Latchaw RE,       Self                        WALLENBERG
       Wendling LR, Gold LHA.                                      SYNDROME
                                       Male 20
       Vertebrobasilar
                                       Vertebrobasilar
       injuries following cervical
       manipulation.                   Injuries following
                                       cervical manipulation.
       J.A.M.A. 1980; 244 (13):

       1450-3.


1981   Ladermann JP. Accidents of      Practitioner:               WALLENBERG
       spinal manipulation.            Chiropractor                SYNDROME

       Ann Swiss Chiropractors         Male 35
       Association. 1981; 7: 161-
       208.


1981   Ladermann JP. Accidents of      Practitioner:               RESIDUAL DEFECTS
       spinal manipulation.            Chiropractor

       Ann Swiss Chiropractors         Patient: female 34
       Association. 1981; 7: 161-
       208.                            After neck manipulation
                                       had vomiting, facial
                                       paresis and mild
                                       respiratory paralysis.
1981   Sherman DG, Hart RG,            Practitioner:               VISUAL DEFECTS. RIGHT
       Easton JD. Abrupt change in     Chiropractor                SUPERIOR HOMONYMOUS
       head position and                                           HEMIANOPIA.
                                       Patient: female 39
       cerebral infarction. Stroke
       1981; 12 (1): 2-6. (Note: The   Posterior cerebral artery
       first three cases               thrombosis.

       were previously reported in
       Easton 1977).
1981   Sherman DG, Hart RG,            Practitioner:               MINOR RESIDUAL
       Easton JD. Abrupt change in                                 DEFECTS.
       head position and               Chiropractor

       cerebral infarction. Stroke     Male 35
       1981; 12 (1): 2-6. (Note: The
       first three cases               Stenosis of left vertebral
                                       artery at C-1-2
       were previously reported in
       Easton 1977).
1981   Sherman DG, Hart RG,            Practitioner:                DEATH 4 days later.
       Easton JD. Abrupt change in     Chiropractor                 Unconscious almost
       head position and                                            immediately.
                                       Patient: female age 60
       cerebral infarction. Stroke
       1981; 12 (1): 2-6. (Note:       Microscopic perforation
       Some cases were previously      of the extra-cranial
       reported by Easton 1977).       vertebral artery at the C-
                                       1 level. Upper cervical
                                       spinal cord subarachnoid
                                       hemorrhage
1981   Sherman DG, Hart RG,            Practitioner:                HORNER’S SYNDROME
       Easton JD. Abrupt change in     Chiropractor                 AND SENSORY DEFECIT.
       head position and
                                       Male 24
       cerebral infarction. Stroke
       1981; 12 (1): 2-6. (Note: The   Right vertebral artery
       first three cases               thrombosis.

       were previously reported in
       Easton 1977).
1981   Frachon M. Les accidents        Practitioner: Unknown        RECOVERED?
       neurologiques des
       manipulations cervicales.       Patient: female age 39

       Thesis (Doctor of Medicine)     Transient vertebral artery
       - Faculty of Medicine,          spasm.
       Claude-Bernard University,
       Lyon. 1981 (11 June).
1981   Frachon M. Les accidents        Practitioner: Unknown        WALLENBERG
       neurologiques des                                            SYNDROME.
       manipulations cervicales.       Patient: female 33

       Thesis (Doctor of Medicine)     Left vertebral artery
       - Faculty of Medicine,          damage.
       Claude-Bernard University,
       Lyon. 1981 (11 June).
1981   Frachon M. Les accidents        Practitioner:                RECOVERED?
       neurologiques des               Chiropractor
       manipulations cervicales.
                                       Patient: female 39
       Thesis (Doctor of Medicine)
       - Faculty of Medicine,          Vertebral artery stenosis.
       Claude-Bernard University,
       Lyon. 1981 (11 June).
1982   Dahl A, Bjark P, Anke I.        Practitioner:                ATAXIA. UNSTEADY
       Tidsskr Nor Laegeforen          Chiropractor                 GAIT.
       1983; 102 (3) : 155-7.
                                       Patient: female age 35

                                       Cerebrovaskulaere
                                       kompliskasjoner til

                                       manipulasjonsbehandling
                                       av nakken
1982   Meyermann R.                    Practitioner: Physician DEATH a few hours later.
       Moglichkeiten einer
       schadigung der arteria          Patient: female age 36
       vertebralis.
                                       Thrombosis of the
       Manuelle Medizin 1982; 20:      basilar artery
       105-14.
1982   Simmons KC, Soo YS,             Practitioner: Unknown        LIMB CLUMSINESS.
       Walker G, Harvey P. Trauma                                   OCULAR MOBILITY
       to the vertebral artery related Male age 41                  DEFICITS.
       to neck manipulation.
                                       Right vertebral artery
        Med J Australia 1982; 1:       causing brainstem
       187-8.                          ischemia.


1983   Gutmann G. Verletzungen         Practitioner: Physician      DEATH
       der arteria vertebralis durch
       manuelle therapie.              Patient: female age 35.

       Manuelle Medizin 1983; 21:      Dissecting aneurysm of
       2-14.                           the vertebral artery


1983   Gutmann G. Verletzungen         Practitioner: Physician      SPASTIC TETRAPLEGIA
       der arteria vertebralis durch
       manuelle therapie.              Patient: female age 25.

       Manuelle Medizin 1983; 21:      Vertebral artery
       2-14.                           insufficiency.


1983   Gutmann G. Verletzungen         Naturopath                BLINDNESS THEN SEVERE
       der arteria vertebralis durch                             TUNNEL VISION.
       manuelle therapie.              Male age unknown

        Manuelle Medizin 1983; 21:     Vertebral artery
       2-14.                           thrombosis.


1983   Gutmann G. Verletzungen         Naturopath                VERTIGO. NAUSEA.
       der arteria vertebralis durch                             VOMITING
       manuelle therapie.              Male age 36

       Manuelle Medizin 1983; 21:      cerebellar ischemia
       2-14.


1983   Gutmann G. Verletzungen         Practitioner: Physician   BRAINSTEM ISCHAEMIA
       der arteria vertebralis durch
       manuelle therapie.              Male. Age unknown.

        Manuelle Medizin 1983; 21:
       2-14.


1983   Gutmann G. Verletzungen         Practitioner: Physician   VISUAL DISTURBANCES.
       der arteria vertebralis durch                             MEMORY PROBLEMS.
       manuelle therapie. Manuelle     Patient: female age 36
       Medizin 1983; 21: 2-14.
                                       Vertebral artery
                                       insufficiency.
1983   Gutmann G. Verletzungen         Practitioner: Physician   VERTEBRAL ARTERY
       der arteria vertebralis durch                             SPASM.
       manuelle                        Patient: female. Young
                                       age
       therapie. Manuelle Medizin
       1983; 21: 2-14.


1983   Braun IF, Pinto RS, DeFilipp    Practitioner:             PONS INFARCTION
       GJ et al. Southern Med J        Chiropractor
       1983; 76 (9): 1199-1201
                                       Male age 47
                                      Brain stem infarction due
                                      to chiropractic
                                      manipulation of the
                                      cervical spine.


1983   Horn SW.                       Practitioner:               TETRAPLEGIC MUTE. CAN
                                      Chiropractor                ONLY COMMUNICATE BY
       Annals Emergency                                           EYE BLINKING.
       Medicine 1983; 12 (10): 648- Male age 34
       50.
                                    The Locked-In syndrome
                                    following chiropractic
                                    manipulation of

                                      the cervical spine
1983   Pamela F, Beaugerie L,         Practitioner: Unknown       DEATH six weeks later.
       Couturier M et al. Syndrome
       de d                           Patient: female age 52.

       differentiation motrice par    Basilar artery
       thrombose du tronc basilaire   thrombosis. Locked in
       apres manipulation             syndrome.
       vertebrale.

       Presse Medicale 1983; 12
       (24): 1548.
1983   Ali Cherif A, Delpuech F,      Practitioner:               DEATH after 11 days of
       Habib M, Salamon G, Khalil     Chiropractor                coma.
       R. Thrombose vertebro-
       basilaire apres manipulation   Male age 51
       du rachis cervical. A propos
       de deux                        Basilar artery
                                      thrombosis.
       cas. Annales de Medecine
       Physique 1983; 25: 459-65.
1983   Ali Cherif A, Delpuech F,      Practitioner: Unknown       VARIOUS
       Habib M, Salamon G, Khalil                                 NEUROLOGICAL
       R. Thrombose vertebro-         Male age 65                 DEFICITS.
       basilaire apres manipulation
       du rachis cervical. A propos   vertebral artery
       de deux                        thrombosis.

       cas. Annales de Medecine
       Physique 1983; 25: 459-65.
1984   Cellerier P, Georget AM.       Practitioner:               WALLENBERG
       Dissection des arteres         Chiropractor            SYNDROME
       vertebrales apres
                                      Male age 35
       manipulation du rachis
       cervical. A propos d'un cas.   Dissections of the
                                      vertebral artery.
       J Radio1 1984; 65 (3): 191-6.
1984   Daneshmend TK, Hewer RL, Osteopath                     RESIDUAL PALSY
       Bradshaw JR. Acute brain
       stem stroke during neck       Male age 31
       manipulation.
                                     Acute brainstem and
       Br Med J 1984; 288: 189.      cerebellar infarction.


1984   Fritz VU, Maloon A, Tuch P. Osteopath                  ATAXIA. NAUSEA. RIGHT
       Neck manipulation causing                              ARM WEAKNESS.
       stroke. South               Patient: female age 60

       African Med J 1984; 66:
       844-6.




1984   Fritz VU, Maloon A, Tuch P. Practitioner:              PONTINE BRAINSTEM
       Neck manipulation causing   Chiropractor               INFARCT.
       stroke.
                                   Patient: female age 31
       South African Medical
       Journal 1984; 66: 844-6.




1984   Fritz VU, Maloon A, Tuch P. Practitioner:              HEMIPARESIS. DIZZY
       Neck manipulation causing   Physiotherapist            SPELLS.
       stroke. South African
       Medical Journal 1984; 66:   Male 63
       844-6.
                                   Brainstem infarct.



1984   Lindy DR.                      Osteopath               RECOVERED?
       Patient collapse following      Male age 43
       cervical manipulation: A
                                       vertebral artery
       case report.

       Br Osteopathic J 1984; 16
       (2): 84-5.


1984   Nielsen AA.                     Practitioner:                DEATH ABOUT 3 HOURS
                                       Chiropractor                 AFTER NECK
       Cerebrovaskulaere insulter                                   MANIPULATION.
       forarsaget af manipulation af   Male age 34

       columna cervicalis.             Dissecting aneurysm of
                                       the vertebral artery
       Ugeskr Lager 1984 (22 Oct);
       3267-70.


1984   Nielsen AA.                     Practitioner: Physician      RESIDUAL
       Cerebrovaskulaere insulter                                   NEUROLOGICAL
       forarsaget af manipulation af   Patient: female age 41       DEFICITS.
       columna cervicalis.
                                       vertebral artery
       Ugeskr Lager 1984 (22 Oct);
       3267-70.


1984   Zak SM, Carmody RF.             Practitioner:                DEATH 27 days after neck
       Cerebellar infarction from      Chiropractor                 manipulation.
       chiropractic neck
       manipulation: Case report       Male age 53
       and review of the literature.
                                       posterior inferior and
       Arizona Medical 1984; 41        superior cerebellar artery
                                       thrombosis.
       (5): 333-7.


1985   Bayerl JR, Buchmuller HR,       Practitioner: Physician      VOMITING. DOUBLE
       Pohlmann-Eden B.                                             VISION. SPEECH DEFECTS.
       Nebenwirkungen und              Male age 32.

       Kontraindikationen der
       manuellen therapie im
       bereich der halswirbelsaule.

       Nervenarzt 1985; 56 (4):
       194-9.
1985   Bayerl JR, Buchmuller HR,      Practitioner:             BLURRED VISION
       Pohlmann-Eden B.               Physiotherapist
       Nebenwirkungen und
                                      Patient: female age 33
       Kontraindikationen der
       manuellen therapie im
       bereich der halswirbelsaule.

       Nervenarzt 1985; 56 (4):
       194-9.
1985   Bayerl JR, Buchmuller HR,      Practitioner: Unknown     NYSTAGMUS. SHORT
       Pohlmann-Eden B.                                         TERM BLINDNESS.
       Nebenwirkungen und             Patient: female age 33

       Kontraindikationen der
       manuellen therapie im
       bereich der halswirbelsaule.

       Nervenarzt 1985; 56 (4):
       194-9.
1985   Bayerl JR, Buchmuller HR,      Practitioner: Physician   VISUAL AND SPEECH
       Pohlmann-Eden B.                                         DEFICITS.
       Nebenwirkungen und             Patient: female age 43

       Kontraindikationen der
       manuellen therapie im
       bereich der halswirbelsaule.

       Nervenarzt 1985; 56 (4):
       194-9.
1985   Bayerl JR, Buchmuller HR,      Practitioner: Physician   NAUSEA
       Pohlmann-Eden B.
       Nebenwirkungen und             Patient: female age 27

       Kontraindikationen der
       manuellen therapie im
       bereich der halswirbelsaule.

       Nervenarzt 1985; 56 (4):
       194-9.
1985   Katirji MB, Reinmuth OM,       Practitioner: Unknown     ATAXIA. HYPALGESIA.
       Latchaw RE.                   Patient: female age 26

       Arch Neurol 1985; 42: 242-    Stroke due to vertebral
       8.                            artery injury.


1985   Katirji MB, Reinmuth OM,      Practitioner:              WALLENBERG
       Latchaw RE                    Chiropractor               SYNDROME

       Arch Neurol 1985; 42: 242-    Male age 51
       8.
                                      Stroke due to vertebral
                                     artery injury.
1985   Modde PJ. Chiropractic        Practitioner:              SLURRED SPEECH.
       Malpractice. Columbia,        Chiropractor               FACIAL PARALYSIS.
       Maryland: Hanrow Press
                                     Patient: female age 32
       1985: 269-70, 273-5, 311-8,
       322-3, 329-31, 334-7.


1985   Modde PJ. Chiropractic        Practitioner:              BRAINSTEM INFARCTION.
       Malpractice. Columbia,        Chiropractor               VERTIGO
       Maryland: Hanrow Press
                                     Male age 41
       1985: 269-70, 273-5, 311-8,
       322-3, 329-31, 334-7.


1985   Modde PJ. Chiropractic        Practitioner:              PROGRESSIVE
       Malpractice. Columbia,        Chiropractor               PARALYSIS. VISUAL
       Maryland: Hanrow Press                                   DEFECTS.
                                     Patient: female age 29
       1985: 269-70, 273-5, 311-8,
       322-3, 329-31, 334-7.         Immediate following
                                     neck manipulation,
                                     headaches, dizziness.
1985   Modde PJ. Chiropractic        Practitioner:              BRAINSTEM STROKE.
       Malpractice. Columbia,        Chiropractor               DIZZY SPELLS.
       Maryland: Hanrow Press
                                     Male age 31
       1985: 269-70, 273-5, 311-8,
       322-3, 329-31, 334-7.         Nausea. Unable to stand


1985   Modde PJ. Chiropractic        Practitioner:              DEATH 24 hours after neck
       Malpractice. Columbia,         Chiropractor              manipulation.
       Maryland: Hanrow Press
                                      Patient: female age 26
       1985: 269-70, 273-5, 311-8,
       322-3, 329-31, 334-7.          Left vertebral artery
                                      thrombosis and moderate
                                      right vertebral artery
                                      thrombosis.
1985   Dvorak J, Orelli F.            Practitioner:             TRANSIENT
                                      Chiropractor              TETRAPLEGIA.
       Med 1982; 71: 64-9. .
                                      Patient: female age 35.
       Manual Med 1985; 2: 1-4.
                                      Loss of consciousness.



1986   Brownson RJ, Zollinger WK, Osteopath                     SENSORINEURAL
       Madiera T, Fell D. Sudden                                HEARING LOSS
       sensorineural              Patient: female age 29

       hearing loss following         brainstem ischemia.
       manipulation of the cervical
       spine. Laryngoscope

       1986; 96 (2): 166-70.


1986   Brownson RJ, Zollinger WK, Practitioner:                 SENSORINEURAL
       Madiera T, Fell D. Sudden    Chiropractor                HEARING LOSS
       sensorineural
                                    Male age 45
       hearing loss following
       manipulation of the cervical brainstem ischemia.
       spine. Laryngoscope

       1986; 96 (2): 166-70.


1986   Brownson RJ, Zollinger WK, Practitioner:
       Madiera T, Fell D. Sudden    Chiropractor
       sensorineural
                                    Male age 45
       hearing loss following
       manipulation of the cervical
       spine. Laryngoscope            brainstem ischemia.

       1986; 96 (2): 166-70.


1986   Miglets AS. Discussion IN: Practitioner: Physician        HEARING LOSS.
       Brownson RJ, Zollinger WK,
       Madiera T, Fell            Patient: female age 26

       D. Sudden sensorineural        brainstem ischemia.
       hearing loss following
       manipulatin of the cervical

       spine. Laryngoscope 1986;
       96 (2): 166.70.


1986   Gittinger JW. Occipital        Practitioner:              HOMONYMOUS
       infarction following           Chiropractor               HEMIANOPIA.
       chiropractic cervical
                                      Male age 44
       manipulation. J Clinical
       Neuro Ophthalmology 1986;
       6 (1): 11-13.


1987   Terrett AGJ.                   Practitioner:              WALLENBERG
                                      Chiropractor               SYNDROME
       REPORT ON 107 CASES
                                      Male age 42
       Vascular accidents from
       cervical spine manipulation:   Action against
                                      chiropractor: Blood flow
       J Aust Chiro Assoc 1987; 17    to brain disturbed says
       (1): 15-24.                    expert.

                                      Visit to chiropractor
                                      ended working life.

                                      Patient wins claim
                                      against chiropractor.
                                      Border Morning Mail (

                                      Albury, Australia) 24
                                      Nov 1983.
1987   Terrett AGJ.                   Practitioner:                 WALLENBERG
                                      Chiropractor                  SYNDROME
       REPORT ON 107 CASES
                                      Patient: female 29
       Vascular accidents from
       cervical spine manipulation:   Dissection of the
                                      vertebral artery.
       J Aust Chiro Assoc 1987; 17
       (1): 15-24.
1987   Terrett AGJ.                   Practitioner: Physician       DEATH 3 days after neck
                                                                    manipulation.
       REPORT ON 107 CASES            Male age 43

       Vascular accidents from        brainstem and cerebellar
       cervical spine manipulation:   infarction.

       J Aust Chiro Assoc 1987; 17
       (1): 15-24.
1987   Terrett AGJ.                   Practitioner: Physician       DEATH 3 days after neck
                                                                    manipulation.
       REPORT ON 107 CASES            Male age 31

       Vascular accidents from        vertebrobasilar
       cervical spine manipulation:   thrombosis.

       J Aust Chiro Assoc 1987; 17
       (1): 15-24.
1987   Bolton SP. Vascular            Osteopath                     DEATH 18 hours after neck
       accidents. J Aust Chiro                                      manipulation.
       Assoc 1987; 17 (2): 75.        Male age 39

                                      Cerebellopontine
                                      infarction following
                                      bilateral dissection of the
                                      vertebral arteries.
1987   Fast A, Zinicola DF, Marin     Practitioner:                 NEUROLOGICAL
       EL. Vertebral artery damage    Chiropractor                  MODERATE DEFICITS.
       complicating
                                      Patient: female age 27
       cervical manipulation. Spine
       1987; 12 (9): 840-2.           Subintimal tear of the
                                      left vertebral artery.

1987   Jentzen JM, Amatuzio J,        Practitioner:                 DEATH Important example of
       Peterson GF                    Chiropractor                  how anomalies can cause
                                                                    death. No way to know
         Complication of cervical        Male age 51                 beforehand.
         manipulation:
                                         A case report of fatal
         J Forensic Science 1987; 32     brainstem infarct with
         (4): 1089-94.                   review of the               Hypoplastic left vertebral
                                         mechanisms and              artery. Adventitial hemorrhage
                                         predisposing factors.       of the extra-cranial segment o
                                                                     the right vertebral artery
                                         Symptoms 30 minutes
                                         after manipulation

                                         51 male
1987     Sherman MR, Smialek JE,         Practitioner:               DEATH 52 hours after neck
         Zane WE.                        Chiropractor                manipulation.
(M.P.)
         Archives of Pathology and       37male                      NOTE: Patient was a regular
         Laboratory Medicine.                                        chiropractic visitor. He had
         111:851-853(9)1987              Pathogenesis of vertebral   asymmetrical vertebral
                                         artery Occlusion            arteries. He had old and recent
                                         following cervical spine    dissections C-1-2. He had no
                                         manipulation.               knowledge that he already had
                                                                     old dissections in his arteries.
1987     Povlsen UJ, Kjaer L,Arlien-     Practitioner:               LOCKED IN SYNDROME.
         Soborg P. Locked-In             Chiropractor                TETRAPLEGIC.
         syndrome following cervical
         manipulation.                   Patient: female age 36

         Acta Neurol Scand 1987; 76      Infarction of the pons.
         (6): 486-8.




1987     Carmody E. Buckley P.           Practitioner: Unknown       NEUROLOGICAL DEFICITS
         Hutchison M.
                                         Male age 38
         Irish Medical Journal. 1987:
         80(9): 259-60                   Basilar artery occlusions
                                         following neck
                                         manipulation.
1987     Bell versus Griffiths. Hunter   Osteopath                   BLIND. LOCKED IN
         J (Judl- ent). Supreme                                      SYNDROME.
         Court, Common Law               Male age 32
         Division.,SydneN,: 14 Sep
         1994
1987                Mas JL, Bousser       Practitioner: Unknown    RECOVERED?
          MG, Hasboun D, Laplane D.
          Extracranial vertebral artery   Patient: female age 27
          dissections.
                                          Thrombosis of right
          A REVIEW OF 13 CASES.           vertebral artery

          Stroke 1987; 18 (6): 1037-48


1987                Mas JL, Bousser       Practitioner: Unknown    RECOVERED?
          MG, Hasboun D, Laplane D.
          Extracranial vertebral artery   Patient: female age 47
          dissections.
                                          Thrombosis of left
          A REVIEW OF 13 CASES.           vertebral artery.

          Stroke 1987; 18 (6): 1037-48


1987                Chen TW, Chen       Muscle therapist.          RECOVERED?
          ST Brainstem stroke induced
          bN chiro practic neck         Male age 28
          manipulation - a case report.
          Chung Hua I Hsueh Tsa Chih
          (Chinese Medical journal)
          198-1; 40 (6) 557-(i2.




1987      Dunne DW, Conacher GN,          Naturopath               DEATH 3 days after.
          Khangure M.
M.P.                                   Male age 43                 There was “a possible old
          Journal of Neurology,                                    small” dissection of the extra-
          Neurosurgery and             Bilateral dissection of     cranial artery. Another
          Psychiatry. 50:349-353. 1987 the extra-cranial           example where existing
                                       vertebral arteries.         dissections are not known to
                                       Brainstem infarction        the patient.
1987      FAMILY STATEMENT             Practitioner:               DEATH after several months
                                       Chiropractor                in coma.
neck911   ONTARIO
data                                   Patient: female age 30-
          CANADA                       34
                                         Bilateral carotid artery
                                         dissection.
1988       Murthy JMK, Naidu KV.         Barber                     NEUROLOGICAL
          Aneurysm of the cervical                                  DEFICITS.
          internal carotid artery        Male age 40 years.
          following chiropractic         Aneurysm of the left
          manipulation. Neurol           internal carotid artery.
          Neurosurg Psychiatri, 1988:
          51 (9): 1237-8.




1988              Phillips SJ,
          Maloney WJ. Gray J.

          Pure motor stroke due
          vertebral artery dissection.

          Can Journal Neurological
          Science 1989; 16 (3 348-51.


1989                Ponge T, Cottin S,
          Ponge

          .Accident vasculaire
          vert6bro-basilaire apres
          manipulation du rachis
          cervical.

           Rev Rhum 1989; 56 (7):545-
          8.




1989               Mas JL, Henin D,      35 Patient: female         DEATH after 16 hours. Recent
          Bousser MG, Chain F. Hauw      comatose within 15         superimposed on old
neck911   JJ                             minutes                    dissection of the extracranial
                                                                    segment of the right vertebral
          Dissecting aneurysm of the                                artery. (You can have an old
          vertebral artery.                                         dissection and never know it.

          Neurology 1989; 39: 512-
          515, 1989.
1989             Levine SR, Quint        Practitioner: Unknown       SROKE. RECOVERED?
       DJ, Pressin MS, Boulos
       RS,Welch                          Male age 36

       Intramural clot in the            infarction in superior
       vertebrobasilar                   cerebellar artery
       circulation:           Clinical   territory.
       and radiologic features.
       Neurology. 1989 (Apr)

       39: 515-22.
1990   TerrettAGJ.                       Osteopath                   SEVERE NEUROLOGICAL
                                                                     DEFICITS.
       J New Zealand Register of         Male age 31 years.
       Osteopaths I 990; 4: 42-5.
                                         Vertebral artery
                                         thrombosis.


1990   TerrettAGJ.                       Osteopath                   SEVERE NEUROLOGICAL
                                                                     DEFICITS.
       J New Zealand Register of         Male. Age unknown.
       Osteopaths I 990; 4: 42-5.
                                         Thrombosis left posterior
                                         cerebral artery


1990             Frumkin LR, Baloh       Practitioner:               WALLENBERG
       RW. Wallenberg's syndrome         Chiropractor                SYNDROME
       following neck
       manipulation. Neurology           Patient: female age 40
       1990; 40 (4):611-5.               years


1990             Frumkin LR, Baloh Practitioner:                     WALLENBERG
       RW. Wallenberg's syndrome Chiropractor                        SYNDROME
       following neck
       manipulation. Neurology     Male age 33 years
       1990; 40 (4):611-5.


1990            Frumkin LR, Baloh Practitioner:                      WALLENBERG
       RW. Wallenberg's syndrome Chiropractor                        SYNDROME
       following neck
       manipulation. Neurology    Patient: female age 40
       1990; 40 (4):611-5.


1990             Frumkin LR, Baloh Practitioner:                    WALLENBERG
       RW. Wallenberg's syndrome Chiropractor                       SYNDROME
       following neck
       manipulation. Neurology     Male age 28
       1990; 40 (4):611-5.


1990            Raskind R, North      Practitioner:                 DEATH
       CM.                            Chiropractor

       Vertebral artery injuries      Patient: female age 43
       following chiropractic
       cervical spine manipulation.   cerebellar hemmorhage

       Angiology 1990; 41 (6):445-
       52.




1990            Raskind R, North      Practitioner:                 NEUROLOGICAL
       CM.                            Chiropractor                  DEFICITS.

       Vertebral artery injuries      Male age 42
       following chiropractic
       cervical spine manipulation.   subintimal tear of the left
                                      vertebral artery.
       Angiology 1990; 41 (6):445-    Abnormal right vertebral
       52.                            artery as well.




1990            Raskind R, North      Practitioner:                 BRAINSTEM.
       CM.                            Chiropractor                  NEUROLOGICAL
                                                                    DEFICITS.
       Vertebral artery injuries      Patient: female age 40
       following chiropractic
       cervical spine manipulation.   bilateral subintimal
                                      dissection.
       Angiology 1990; 41 (6):445-
       52.
1990   Krieger D, Leibold M,          Practitioner:                LOCKED IN SYNDROME.
       Bruckmann H.                   Chiropractor
                                                                   SOME RESOLUTION.
       Dissektionen der               Patient: female age 37
                                      years
       arteria vertebralis nach
       zervikalen chiropraktischen

       manipulationen.

       Deutsche Med Wochenschr
       1990; 115 (15):580-3
1990    Krieger D, Leibold M,         Practitioner: Unknown        HEMIPARESIS.
       Bruckmann H.
                                      Patient: female age 39
       Dissektionen der
                                      Bilateral vertebral artery
       arteria vertebralis nach       dissections. Basilar
       zervikalen chiropraktischen    artery embolism

       manipulationen.

       Deutsche Med Wochenschr
       1990; 115 (15):580-3
1990    Maln J, Olsson T, Fagerlund   Practitioner: Unknown        UNKNOWN

       Cervikal manipulation          Male age 28

       kan ge hjarninfarkt.           Thalamus infarct in the
       Lakartidningen 1990 (Nov       area of the basilar artery
       14); 87 (46):3877-9
1990    Maln J, Olsson T, Fagerlund   Practitioner: Unknown        RIGHT HEMIANOPIA

       Cervikal manipulation          Patient: female age 27

       kan ge hjarninfarkt.           Occipital lobe infarction
       Lakartidningen 1990 (Nov
       14); 87 (46):3877-9
1991             Frisoni GB.Anzola    Practitioner: Physician      BRAINSTEM AND
       GP                                                          CEREBELLAR
                                      Male age 41                  NEUROLOGICAL
       Vertebrobasilar ischaemia                                   DEFECTS.
       after neck motion.

       Stroke 1991; 22 (11):1452-
       60
1991            Frisoni GB.Anzola      Practitioner:            NEUROLOGICAL
       GP                              Physiotherapist          DEFICITS.

       Vertebrobasilar ischaemia       Patient: female age 39
       after neck motion.
                                       Vertebral artery
       Stroke 1991; 22 (11):1452-      dissection at C-1
       60
1991            Frisoni GB.Anzola      Practitioner:            CEREBELLAR
       GP                              Physiotherapist          HEMORRHAGE.

       Vertebrobasilar ischaemia       Patient: female age 49
       after neck motion.

       Stroke 1991; 22 (11):1452-
       60
1991             Rothrock JF,          Self                     MILD STROKE.
       Hesselink JR, TeacherTM.
       Vertebral artery occlusion      Male age 35
       and stroke from cervical self
       manipulation.                   Left vertebral artery
                                       thrombosis.
       Neurology 1991; 41
       (10):1696-7.
1991             Cook JW, Sanstead Self                         RESIDUAL
       JK. Wallenberg syndrome                                  NEUROLOGICAL DEFICIT.
       following self induced      Patient: female age 35
       manipulation. Neurology
       199 1; 41 (IO): 1695-6.     Right inferior
                                   cerebellum, right lateral
                                   medulla, right cerebellar
                                   peduncle.
1991    Braune Hj, Mutik MH,       Practitioner: Physician      MODERATE
       Huffmann G. Hirninfarkt im                               NEUROLOGICAL DEFICIT.
       stromgebiet der arteria     Male age 59
       cerebri media nach
       chirotherapie der           Right middle cerebral
       balswirbelsdule.            artery

       Deutsche Med Wochenschr
       199 1; 116 (27):1047-50.
1991   Nakamura CT, Lau JM, Polk       Practitioner:            MILD NEUROLOGICAL
       NO, Popper JS.                   Chiropractor                 DEFICITS.

       Vertebral artery dissection      Patient: female age 34
       caused by chiropractic
       manipulation.                    vertebral artery
                                        dissection.
       Journal Vascular Surgery
       1991; 14 (1):1224.
1991             Weinstein SM,          Practitioner:                NEUROLOGICAL
       Cantu RC. Cerebral stroke        Chiropractor                 DEFICITS.
       in a semi-pro football player.
       A case report. Med Sci           Male age 29
       Sports Exerc 1991; 23
       (10):1119-21.                    thrombosis vertebral
                                        artery
1991             Saltzberg v            Practitioner: Physician      PERMANENT
       Hawkins. Los Angeles                                          NEUROLOGICAL DEFICIT.
       County Superior Court Case       Patient: female age 31
       No. 697925. Kakita J and
       jury. Judgement 13 Nov           bilateral dissection, left
       1991. $1.3 million award         and right vertebral
       against MD.                      arteries.
1992             Sullivan EC. Brain     Practitioner:                DEATH eight hours after neck
       stem stroke syndromes from       Chiropractor                 manipulation.
       cervical adjustments: Report
       on five cases.                   Patient: female age 41

       Journal Chiropractic
       Research & Clinical
       investigation 1992; 8 (1): 12-
       16.
1992             Sullivan EC. Brain Practitioner:                    BRAINSTEM AND
       stem stroke syndromes from Chiropractor                       CEREBELLAR
       cervical adjustments: Report                                  INFARCTION
       on five cases.                 Male age 44

       Journal Chiropractic             left vertebral artery.
       Research & Clinical
       investigation 1992; 8 (1): 12-
       16.
1992             Sullivan EC. Brain     Practitioner:                WALLENBERG
       stem stroke syndromes from       Chiropractor                 SYNDROME THALAMUS
       cervical adjustments: Report                                  INFARCT
       on five cases.                   Patient: female age 41

       Journal Chiropractic
            Research & Clinical
            investigation 1992; 8 (1): 12-
            16.
1992                  Sullivan EC. Brain Practitioner:                     BRAINSTEM STROKE.
            stem stroke syndromes from Chiropractor
            cervical adjustments: Report
            on five cases.                 Male age 36 years

            Journal Chiropractic
            Research & Clinical
            investigation 1992; 8 (1): 12-
            16.
1992        Shafir. J. Pediatrics 1992;      Practitioner:                 QUADRIPLEGIA
            120:226-9                        Chiropractor

                                             Male infant.

                                         rupture of spinal cord
                                         astrocytoma.
1992                  Sullivan EC. Brain Practitioner:                     NEUROLOGICAL DEFICITS
            stem stroke syndromes from Chiropractor
            cervical adjustments: Report
            on five cases.               Patient: female age 37

            Journal Chiropractic             Subintimal dissection of
            Research & Clinical              the right vertebral artery.
            investigation 1992; 8 (1): 12-
            16.
1992        McCarty Sue Ky.                  Practitioner:                 HEMIPLEGIC
                                             Chiropractor
neck911
case file                                    Patient: female age 39

                                             Bilateral vertebral artery
                                             dissection.
1992        Friedman DP, Flanders AE.        Practitioner:                 NEUROLOGICAL
            Unusual dissection of the        Chiropractor                  DEFICITS.
            proximal vertebral artery:
            Description of three cases.      Male age 35
            Am J Neuro-radiology 1992
            (Jan/Feb); 13:283-6.             Dissection of both
                                             vertebral arteries with
                                             cerebellar infarction.
1992   Kponkton A, Hamonet C,        Practitioner: Unknown        TETRAPLEGIA.
       Montagne A, Devaifty JP.
       Complications de la           Patient: female age 29
       manipulation cervicate. Une   years
       observation de'locked-in
       syndrome." Presse Med
       1992; 21: 2050-2.
1993   Johnson DW.                   Self                         LEFT FACIAL PARESIS

       Cervical self-manipulation    Male age 26
       and stroke.
                                     Vertebral artery spasm
        Med J Aust 1993; 158
       (4):290.
1993   Hamaan G, Felber S,           Lay person                   NEUROLOGICAL
       Cervicocephalic artery                                     DEFICITS.
       dissections due to            Patient: female age 30
       chiropractic manipulations.
                                     Left vertebral artery
       Lancet 1993; 341: 764-5.      dissection.


1993    Hamaan G, Felber S,          Practitioner: Physician      NEUROLOGICAL
       Cervicocephalic artery                                     DEFICITS.
       dissections due to            Male age 38
       chiropractic manipulations.
                                     Left vertebral artery
       Lancet 1993; 341: 764-5.      dissection.


1993    Hamaan G, Felber S,          Practitioner: Physician      NEUROLOGICAL
       Cervicocephalic artery                                     DEFICITS.
       dissections due to            Patient: female age 31
       chiropractic manipulations.
                                     Left and right vertebral
       Lancet 1993; 341: 764-5.      artery dissections


1993    Hamaan G, Felber S,          Practitioner: Physician      RECOVERED?
        Cervicocephalic artery
       dissections due to            Patient: female age 31
       chiropractic manipulations.
                                     Bilateral vertebral artery
       Lancet 1993; 341: 764-5.      dissection.
1993   Sinel M, Smith D.             Practitioner: Unknown     QUADRIPARESIS. SPEECH
                                                               DEFECT. NYSTAGMUS
       Thalamic infarction           Patient: female age 32
       secondary to cervical
       manipulation.                 intimal tearing of the
                                     vertebral artery
       Arch Phys Med
       Rehabilitation 1993; 74: 543-
       6.
1993   Vibert D, Rohr Le Floch J,    Practitioner:             RECOVERED?
       Gauthier G.                   Chiropractor

       Vertigo as manifestation of   Patient: female age 33
       vertebral artery dissection
       after chiropractic neck       Vertebral artery
       manipulations Journal Oto-    dissection
       Rhino-laryngology 1993; 55:
       140-2.


1993   Soragna D, Montalbetti L,     Practitioner:             RECOVERED?
       Chiropractic complications    Chiropractor
       Another case report.
                                     Male age 34
       Acta Neurol (Napoli) 1993
       (Apr); 15 (2):145-50.         cerebellar infarction.




1993   Braus DF, Mainka R.           Practitioner: Unknown     WALLENBERG
       Schlaganfall nach manueller                             SYNDROME
                                     Patient: female age 26
       therapie: Rationale
       diagnostik. Manual Medizin
       1993; 31:92-6.


1993   Braus DF, Mainka R.           Practitioner: Physician   VISUAL DEFECITS. ARM
       Schlaganfall nach manueller                             PARESIS.
                                     Male age 60
       therapie: Rationale
       diagnostik. Manual Medizin
       1993; 31:92-6.
1993        Sturzenegger M.           Practitioner: Physician   WALLEMBERG
                                                                SYNDROME
            Dissektion der arteria    Male age 41
            vertebralis nach                                    DOUBLE VISION. ATAXIA
            manipulation der
            halswirbelsiiule.

            Schweiz Med Wochenschr
            1993 (Jul 13); 123 (27-
            28):1389-99.


1993        Frazier Tina California   Practitioner:             DOUBLE VISION
                                      Chiropractor
Neck911
case file                             Patient: female age 36

                                      Brainstem stroke
1993        Sturzenegger M.           Practitioner: Physician   WALLENBERG
                                                                SYNDROME.
            Dissektion der arteria    Male age 40
            vertebralis nach
            manipulation der
            halswirbelsiiule.

            Schweiz Med Wochenschr
            1993 (Jul 13); 123 (27-
            28):1389-99.


1993        Badenbaugh K.             Practitioner:             DEATH
                                      Chiropractor
Neck911
case file                             Age 24

                                      Vertebral artery
                                      dissection. Brain stem
                                      infarction.
1993        Michaeli A.               Practitioner:             APHASIA. STROKE.
                                      Physiotherapist.
            Reported occurrence and
            nature of complications   Male age 75.
            following manipulative
            physiotherapy in South
            Africa.
             Aust Physio 1993 (Dec); 39
            (4): 309-15.




1993        Blazer Art. California          Practitioner:              QUADRAPLEGIC
                                            Chiropractor
Neck911
case file                                   Male age 39
1994                  Carmichael JR         Practitioner:              SHORT TERM MEMORY
                                            Chiropractor               LOSS.
            Transient global amnesia
            following rotational            Patient: female age 29
            manipulation of the upper
            cervical spine.                 Proceedings of the 1994
                                            international Conference
                                            On Spinal Manipulation.
                                            Foundation for
                                            Chiropractic Education
                                            and Research,
1994                   Murase S, Ohe N,     Self                       THROMBUS OF
            Nokura H. Vertebral artery                                 VERTEBRAL ARTERIES.
            injury following mild neck      Male 23
            trauma: No Shinkei Geka
            1994; 22 (7):671-6.




1994        Bridges R.                      Practitioner:              QUADRAPLEGIC. LOCKED
                                            Chiropractor               IN SYNDROME.
            Trial or settlement.
            Circumstances that prompt       26 Patient: female.
            the decision.

            J Chiropr 1994; 31 (I I): 44-
            7.




1994                  Lofberg M,            Practitioner: Unknown      SEVERE NEUROLOGICAL
            Hurskainen K, Dissection of                                DEFICITS.
            a vertebral artery as a         Male age 35
            complication of neck
          manipulation.                  vertebral artery stenosis.

          Duodecim 1994:110
          (12):1155-9.




1994      Teasell RW, MarchukY           Practitioner:                NEUROLOGICAL
                                         Chiropractor                 DEFICITS.
          Vertebro-basilar artery,
          stroke as a complication of    Patient: female age 32
          cervical manipulation.
          Critical Reviews in Physical   Bilateral vertebral artery
          & Rehabilitation Medicine      dissections.
          1994; 6(1):121-9.




1994      R.D. Ontario                   Practitioner:                QUADRAPLEGIC
                                         Chiropractor
neck911   CANADA
data                                     Patient: female age 30
1995               Rosa A, Klein J,      Practitioner: Unknown        DEATH 1 month later.
          Penisson-Besnier I, Dubas E
                                         Male age 48.
          Hematome cerebelleux apres
          manipulations cervicales       Left cerebral bleed.
          chez on homnie de 48 ans.

          Rev Neurol (Paris) 1995; 151
          (12): 739-43.




1995      Autopsy report                 Practitioner:                DEATH
                                         Chiropractor
          QUEBEC                                                      Shows the importance of
                                         Patient: female age 30-      underlying left vertebral PICA
          CANADA                         35                           termination.

                                         Thrombosis of right
                                         vertebral artery.
                                         Dissection. Abnormal
                                      left vertebral artery.
1995           Soper JR, Parker       Practitioner: Physician      NEUROLOGICAL DEFICIT.
       GD, Hallman JM.
                                      Patient: female age 26
       Vertebral artery dissection
       diagnosed with CT.             Bilateral vertebral artery
                                      dissection.
       Am J Neuroradiol 1995
       (Apr); 16 (4 Suppl): 95 2-4.




1995   Wang JL, Lin JJ                Practitioner:                CEREBELLAR ATAXIA.
                                      Chiropractor
       Vertebral artery dissection
       complicated by cervical        Male age 32
       manipulation: A case report.
       Chung Hua I Hsueh Tsa          Right vertebral artery
       Chih (Taipei) 1995 (Jun); 55   dissection.
       (6):496-500.


1995   Peters M, Bohl J,Thonike I,    Practitioner:                DEATH 3 months later.
       Dissection of the internal     Chiropractor
       carotid artery after
       chiropractic manipulation of   Patient: female age 29
       the neck. Neurology 1995;
       45: 2284-6.                    Right hemispheric
                                      infarction.

1995   Sternbach G. Cohen M,          Practitioner:                RECOVERED?
       Goldschntid D.                 Chiropractor

       Vertebral artery injury        Patient: female age 32
       presenting with signs of
       middle cerebral artery         Thrombosis C-2 to intra-
       occlusions case report.        cranial area of vertebral
                                      artery.
       Angiology 1995 (Sep); 46
       (9): 843-6.
1996          Watanabe M,             Practitioner: Unknown       RECOVERED?
       Murayama T, Mano T
                                      Male age 39
        Medial medullary infarction
       following neck                 Lateral medial medulla
       manipulation. Rinsho
       Shinkeigaku 1996 (Jan); 36
       (1):43-6.




1996    AlimiY, Tonolli, DiMauro      Practitioner: Unknown       NEUROLOGICAL DEFICIT.
       P Manipulations.des
       vertebres cervicales et        Patient: female age 48
       traumatisme de l’artere
       vertebrale                     Right vertebral artery
                                      dissection.
       J Mal Vase 1996; 21 (5):
       320-3.


                                      Practitioner:               RECOVERED?
                                      Chiropractor

                                      Male age 48.

                                      Right vertebral artery
                                      dissection.
1996    Yanez GF. Chiropractic        Friend                      STROKE.
       complications.
                                      Patient: female age 30.
        Neurology 1996 (Mar); 46
       (3):884-5, (Discussion 886-    Right superior cerebellar
       7).                            infarct.
1996   Deck J. Pollanen M.            Practitioner:               DEATH sixteen days after
                                      Chiropractor                neck manipulation.
       Neuropathology Autopsy
       report. Lana Dale Lewis,       Patient: female age 45      see internet
       Ontario. Canada                                            www.canoe.ca/ChiroYork

                                                                  CORONER’S INQUEST.
1996   Klougart N, Leboeuf-Yde C,     SUMMARY: “Among             “Spinal manipulation to the
       Rasmussen LR.                  the respondents the         upper neck was about four
                                      reported incidence of       times more commonly
       Treatment to the upper neck    CVI between 1981 and        associated with cerebral
       and the rate of               1988 was about one for     vascular insufficiency than
       cerebrovascular incidents.    every 120,000 cervical     treatment to the lower neck
                                     manipulation treatments.
       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.
1996   Klougart N, Leboeuf-Yde C,    Practitioner:              RECOVERED?
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Patient: female age 40
       and the rate of
       cerebrovascular incidents.    Vertebral artery spasms.

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:              SIMPLE DIZZY SPELLS.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Patient: female age 54
       and the rate of
       cerebrovascular incidents.    dizzy spells

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:              POOR BALANCE. DIZZY
       Rasmussen LR.                 Chiropractor               SPELLS.

       Treatment to the upper neck   Patient: female age 48
       and the rate of
       cerebrovascular incidents.    vertebral-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:              NAUSEA. DIZZY SPELLS.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Patient: female age 53
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:             NAUSEA. POOR BALANCE.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Male age 61
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs.

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:             RECOVERED.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Patient: female age 74
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:             LOSS OF
       Rasmussen LR.                 Chiropractor              CONSCIOUSNESS. VISUAL
                                                               PROBLEMS.
       Treatment to the upper neck   Patient: female age 19
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:             LOSS OF
       Rasmussen LR.                 Chiropractor              CONSCIOUSNESS. VISUAL
                                                               PROBLEMS.
       Treatment to the upper neck   Patient: female age 39
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs.

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.
1996   Klougart N, Leboeuf-Yde C,    Practitioner:            ATAXIA. VISUAL
       Rasmussen LR.                 Chiropractor             PROBLEMS.

       Treatment to the upper neck   Male age 20
       and the rate of
       cerebrovascular incidents.

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            MILD STROKE SIGNS.
       Rasmussen LR.                 Chiropractor             RECOVERED.

       Treatment to the upper neck   Patient: female age 30
       and the rate of
       cerebrovascular incidents.

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            ATAXIA. FATIGUE.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Male age 40
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            LOSS OF CONSCIOUSNESS
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Male age 20
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            LOSS OF CONSCIOUSNESS
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Male age 10
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            TEMPORARY BLINDNESS
       Rasmussen LR.                 Chiropractor             IN ONE EYE.

       Treatment to the upper neck   Patient: female age 44
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            VERTIGO. NAUSEA.
       Rasmussen LR.                 Chiropractor

       Treatment to the upper neck   Patient: female age 51
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            SHORT TERM LOSS OF
       Rasmussen LR.                 Chiropractor             CONSCIOUSNESS.

       Treatment to the upper neck   Male age 45
       and the rate of
       cerebrovascular incidents.    vertebro-basilar signs

       J. Manip Physiol Ther 1996
       (Nov-Dec); 19 (9): 563-9.


1996   Klougart N, Leboeuf-Yde C,    Practitioner:            SHORT TERM LOSS OF
       Rasmussen LR.                 Chiropractor             CONSCIOUSNESS.
            Treatment to the upper neck   Male age 22
            and the rate of
            cerebrovascular incidents.    `vertebro-basilar signs

            J. Manip Physiol Ther 1996
            (Nov-Dec); 19 (9): 563-9.


1996        Klougart N, Leboeuf-Yde C,    Practitioner:              SHORT TERM LOSS OF
            Rasmussen LR.                 Chiropractor               CONSCIOUSNESS

            Treatment to the upper neck   Patient: female age 34
            and the rate of
            cerebrovascular incidents.    vertebro-basilar signs

            J. Manip Physiol Ther 1996
            (Nov-Dec); 19 (9): 563-9.


1996        Klougart N, Leboeuf-Yde C,    Practitioner:              NAUSEA. FAINTING.
            Rasmussen LR.                 Chiropractor               PALE. COLD.

            Treatment to the upper neck   Patient: female age 26
            and the rate of
            cerebrovascular incidents.    vertebro-basilar signs

            J. Manip Physiol Ther 1996
            (Nov-Dec); 19 (9): 563-9.


1996        W.S. Wisconsin                Practitioner:              PERMANENT VISUAL
                                          Chiropractor               DEFECTS
 neck911
case file                                 Male age 38
1996?       Sparks, Sandy                 Practitioner:              QUADRAPLEGIC
                                          Chiropractor
            California
                                          Patient: female under 40
                                          years
1996        Kougart N, Leboeuf-Yde C,     Practitioner:              VERTIGO. CONSTRICTED
            Rasmussen LR.                 Chiropractor               EYE PUPIL. DIZZY SPELLS.

            Treatment to the upper neck   Patient: female age 38
            and the rate of
            cerebrovascular incidents.    vertebro-basilar signs
          J. Manip Physiol Ther 1996
          (Nov-Dec); 19 (9): 563-9.


1996      Kougart N, Leboeuf-Yde C,       Practitioner:              TEMPORRAY LOSS OF
          Rasmussen LR.                   Chiropractor               BLADDER CONTROL.
                                                                     LOSS OF
          Treatment to the upper neck     Patient: female age 30     CONSCIOUSNESS.
          and the rate of
          cerebrovascular incidents.      vertebro-basilar signs

          J. Manip Physiol Ther 1996
          (Nov-Dec); 19 (9): 563-9.


1996      Jumper JM Horton JC.           Practitioner:               RIGHT EYE BLINDNESS.
          Central retinal artery         Chiropractor
          occlusion after manipulation
          of the neck by a chiropractor. Male age 87

          Amer J Ophthalmologv 1996       Central retinal artery
          (Mar): 121 (3):321-2.           occlusion


1996      Litigation.                     Practitioner:              STROKE
                                          Chiropractor
neck911   Quebec
data`                                     Patient: female age under
          CANADA                          40
1996      L. A. Ontario                   Practitioner:             PERMANENT
                                          Chiropractor              HEMIPARESIS. THALAMIC
neck911   CANADA                                                    INFARCT.
data.                                     Male age 49

                                          Basilar artery
                                          thrombosis.
1996      Schievnik WI, Mokri B.          Cervical artery
neck911   Pipegras D. J. Neurology        dissections associated
          1996;243:                       with chiropractic
                                          manipulation of the neck
           Suppl. 2-S92 abstract.
1996                Garner LP, Case       Practitioner:              VISUAL DEFECTS
          WF. Manipulation and            Chiropractor
          atherosclerotic emboli to the
          eye (Letter).                   Male age 59
       Amer Fam Phvsician 1996        Emboli to left superior
       (Jan); 53 (1): 90-1.           temporal artery


1997   Mascalchi M, Bianchi MC,       Practitioner:             RECOVERED?
       Mangiafico S et al.            Chiropractor

       MRI and MR angiography of Male age 35
       vertebral artery dissection.
                                    Thalamic and occipital
       Neuroradiology 1997 (May); infarcts
       39 (5):329-40.




1997             Mascalchi M,       Practitioner:               RECOVERED?
       Bianchi MC, Mangiafico S et Chiropractor
       al.
                                    Male age 64
       MRI and MR angiography of
       vertebral artery dissection. cerebellar and pontine
                                    infarcts
       Neuroradiology 1997 (May);
       39 (5):329-40.




1997           Showalter W,           Practitioner:             RECOVERED?
       Esekogwu V, Newton KI,         Chiropractor

       Vertebral artery dissection.   Male age 36

       Acad Emerg Med 1997            Vertebral artery
       (Oct); 4 (10): 991-5.          dissection




1997            De Bray JM,           Practitioner: Unknown     HEMIPLEGIA.
       Penisson-Besnier I, Dubas F.
                                      Patient: female age 34
       Extracranial vertebrobasilar
       dissections: Diagnosis and     Vertebral artery
                                      dissection.
       prognosis.

       J Neurol Neurosurg
       Psychiatry 1997; 63: 46-51.




1997   De Bray JM, Penisson-          Practitioner: Unknown      WALLENBERG
       Besnier I, Dubas F.                                       SYNDROME.
                                      Patient: female age 34
       Extracranial vertebrobasilar
       dissections: Diagnosis and
       prognosis.

       J Neurol Neurosurg
       Psychiatry 1997; 63: 46-51.




1997   PB, Factor JS.                 Practitioner: Unknown      VISUAL FIELD LOSS.

       Visual field loss resulting    Patient: female age 39
       from cervical Donzis
       chiropractic manipulation.     Infarction of right
                                      inferior occipital lobe.
       Am J Opthalmology 1997;
       123:851-2.


1997   Simnad VI.                     Practitioner:              OCULOMOTOR PALSY
                                      Chiropractor
       Acute onset of painful
       ophthalmoplegia following      Patient: female age 45
       chiropractic manipulation of
       the neck. Initial sign of
       intracranial aneurvsm.

       West J Med 1997; 166: 207-
       10.
1997       Terrett AGJ. A case of death   Practitioner: Physician    DEATH
           following vertebrobasilar
           stroke (VBS) attributed to     Vertebral and basilar
           spinal manipulation therapy.   artery thrombosis.

           The Australian Chiropractor
           1997 (Dec); 16-17
1998                 Cortazzo JM, Tom     Practitioner:              RECOVERED?
           YB. Vertebral artery           Chiropractor
           dissection following
           chiropractic manipulation.     Male age 36

           Am J Emerg Med 1998            Left vertebral artery
           (Oct); 16 (6):619-20.          dissection.




1998       Opeskin K, Burke MP:           Practitioner:              DEATH 3 days after neck
           Vertebral artery trauma.       Chiropractor               manipulation.
           American Journal of
           Forensic Medicine and          Male age 56
           Pathology. 19:1206-217.
           1998                           Intracranial vertebral
                                          artery dissection with
                                          subarachnoid
neck 911                                  hemorrhage.
1998       Macaulay. R.                   Practitioner:              DEATH I DAY AFTER
                                          Chiropractor               NECK MANIPULATION.
           Neuropathologist. Inquest
           testimony.                     Patient: female age 20     INQUEST: LAURIE JEAN
                                                                     MATHIASON SASKATOON
           CANADA                                                    CANADA
1998       Opeskin K, Burke MP:           Practitioner:              DEATH 5 days after neck
           Vertebral artery trauma.       Chiropractor               manipulation.
           American Journal of
           Forensic Medicine and          Male age 28
           Pathology. 19:1206-217.
           1998                            Bilateral extra-cranial
                                          vertebral artery
                                          dissection. Infarctions
                                          posterior cerebral
                                          arteries.
Neck911
1998                Hillier CE, Gross    Practitioner:                UNKNOWN?
          ML.                            Chiropractor

          Sudden onset vomiting and      Patient: female age 38
          vertigo following
          chiropractic neck              Vertebral artery and
          manipulation.                  basilar artery thrombosis.

          Postgrad Med J 1998 (Sep);
          74 (875): 567-8
1998      Neff Scott. D.C.               Unwarranted                  His review of cases
          expert examiner.
                                         Cervical                     he has been
                                         Manipulation                 involved with as a
          www.infojustice.com            and death.                   forensic examiner.
                                         General article.
1999      J.S.W. Virginia                Male age 36                  SEVERE
                                                                      NEUROLOGICAL
neck911                                  vertebral                    DISABILITY.
file                                     artery
                                         dissection
1999               Parenti G, Oriandi    Practitioner:                UNKNOWN
          G, Bianchi M, Renna M.         Chiropractor

          Vertebral and carotid artery   Patient: female age 50
          dissection following
          chiropractic cervical          left vertebral artery
          manipulation.                  dissection.

          Neurosurg Rev 1999 (Oct);
          22 (2-3) 127-9.


1999                Rydell N, Raf L.     Practitioner: Unknown        VISUAL DEFECTS

          Spinal manipulation –          Patient: female age 50       PARALYSIS.
          behandling med stor
          komplikationsrisk.             left vertebral artery
          Lakartidningen 1999 (Aug       dissection.
       25); 96 (34): 3536-40.


1999            Rydell N, Raf L.      Practitioner:            APHASIA AND
                                      Chiropractor             TETRAPLEGIA.
       Spinal manipulation –
       behandling med stor            Male age 47
       komplikationsrisk.
       Lakartidningen 1999 (Aug
       25); 96 (34): 3536-40.


1999             Hufnagel A,          Practitioner: Unknown    RECOVERED?
       Hammers A, Schonle PW,
       Bohm KD, Stroke following      Patient: female age 34
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      VERTIGO
       Hammers A, Schonle PW,
       Bohm KD, Stroke following Male age 40
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      LOCKED IN SYNDROME
       Hammers A, Schonle PW,                                  TETRAPLEGIA.
       Bohm KD, Stroke following Patient: female age 27
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      VERTIGO. DIPLOPIA.
       Hammers A, Schonle PW,                                  HYPESTHESIA FOR PAIN
       Bohm KD, Stroke following Patient: female age 29        AND TEMPERATURE
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,       Practitioner: Unknown       LEFT HYPESTHESIA.
       Hammers A, Schonle PW,                                  ASTHENIA.
       Bohm KD, Stroke following      Patient: female age 29
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      RIGHT HEMIPARESIS.
       Hammers A, Schonle PW,
       Bohm KD, Stroke following Patient: female age 35
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      PERSISTENT VEGETATIVE
       Hammers A, Schonle PW,                                  STATE.
       Bohm KD, Stroke following Patient: female age 31
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      HEMIPLEGIA. ALGESIA.
       Hammers A, Schonle PW,                                  DEPRESSION.
       Bohm KD, Stroke following Patient: female age 34
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      RECOVERED?
       Hammers A, Schonle PW,
       Bohm KD, Stroke following Patient: female age 35
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999             Hufnagel A,        Practitioner: Unknown      DYSARTHRIA.
       Hammers A, Schonle PW,                                  DYSPHASIA
       Bohm KD, Stroke following Patient: female age 46
       chiropractic manipulation of
       the cervical spine.

       J Neurology 1999 (Aug); 246
       (8):683-8
1999      Office of the Medical           Practitioner:                DEATH
          Examiner                        Chiropractor
neck911
data.     San Diego, California. Name     Patient: female age 36
          W.V.
                                          bilateral dissections of
                                          the vertebral arteries.
2000      Norris JW Beletsky V            All cases are                A) GENERALLY CAUSED
          Sudden neck movement and        chiropractic. Specific       ATAXIAS AND
CANADA    cervical artery dissection.     breakdown of age and         QUADRIPARESIS.
                                          sex not available
          REVIEW OF 21 CASES
                                          A) Vertebral artery
                                          dissections                  B) GENERALLY CAUSE
                                                                       HEMIPARESIS. APHASIA
                                          B) Carotid artery
                                          dissections.
2000   Saeed AB Shuaib                    Discussion of                Alberta Study Twenty five
                                                                       patients. “Sports activity and
       A. Vertebral                       cases due to                 chiropractic manipulation were
Review artery dissection.                 chiropractic                 again predominant
                                                                       precipitating factors
1989-  Canadian                           neck
1999   Journal of                         manipulations
CANADA Neurological                       and other
       Sciences.                          causes.
       2000;27:292-296

2000      Whitworth ML.                   vertebral artery             LOSS OF SPEECH
                                          transection
          case report
          www.whiplash101.com
2001      Jacobi G. Riepert T. Uber       Practitioner:                DEATH
          einen todesfall wahrend der     Physiotherapist
          physiotherapie nach vojta bei
          einem 3 monate alten            infant age 3 months
          saugling.
                                          bilateral vertebral artery
          Klin. Padiatr 2001: 213: 76-    dissections.
          85
2001      Rothwell DM, Bondy SJ,          Patients under the age of
          Williams I. Case control        45 with vertebro-basilar
               study of chiropractic        infarcts are five times
               manipulation and stroke.     more likely than controls
               Stroke 2001 (5) 1054-1060    to have visited a
                                            chiropractor within 1
               CANADA                       week of the event.


2001           J.R.S.M. 2002 March. Vol.    Report from                 Brainstem Stroke. Sub-dural
               94 107.                      neurologists.               hematoma.
2001           J R Society Med. 2001        35 cases. These             “Concern about neurological
               Jun;94(6):314-5,                                         complications following
                                            included 7 cases of
               Neurological complications   stroke in brainstem         Cervical spine manipulation
               of cervical spine            territory (4 with           appears to be justified. A large
               manipulation. letter.        confirmation of             long-term

                                            vertebral artery            Prospective study is required
                                            dissection), 2 cases of     to determine the scale of the
                                            stroke in carotid           hazard”.
                                            territory. Sub-dural
                                            hematoma


2001           Stroke 2001;32:1936-a. More Dural tear                   34 year old male.
               Complications of Spinal
               Manipulation.
Recent years   Canadian Stroke Consortium Practitioner:                 DEATH
               data. Pending publication.  Chiropractor

                 ONTARIO CANADA             Male over age 80

				
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