{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:23:01Z","timestamp":1780636981607,"version":"3.54.1"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1991,11]]},"abstract":"<jats:p>Vertebrobasilar ischemic strokes may occur after chiropractic manipulation of the cervical spine or, less often, after spontaneous and abrupt head movement.<\/jats:p>\n          <jats:p>We describe three such cases of vertebrobasilar ischemic strokes and review 36 other reported cases.<\/jats:p>\n          <jats:p>We give evidence that 1) the population at risk cannot be identified a priori in the vast majority of cases; 2) symptoms may develop after many uneventful manipulations; 3) clinical syndromes consist of occipital lobe (5%), cerebellar (8%), locked-in (8%), Wallenberg's (28%), other brain stem (49%), and unclassifiable (2%); 4) mortality or very severe long-term impairment occurs in 28% of cases; 5) the development of transient neurological symptoms during previous manipulations, the presence of known or suspected ligament laxity, and, if known, the presence of a vertebral artery terminating in posterior inferior cerebellar artery should always contraindicate any chiropractic neck maneuver; and 6) the pathogenetic mechanism involves vertebral artery dissection at the atlantoaxial joint with intimal tear, intramural bleeding, or pseudoaneurysm that can lead to thrombosis or embolism.<\/jats:p>","DOI":"10.1161\/01.str.22.11.1452","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1452-1460","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":122,"title":["Vertebrobasilar ischemia after neck motion."],"prefix":"10.1161","volume":"22","author":[{"given":"G B","family":"Frisoni","sequence":"first","affiliation":[{"name":"Clinica Neurologica dell'Universit\u00e0 di Brescia, Spedali Civili, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G P","family":"Anzola","sequence":"additional","affiliation":[{"name":"Clinica Neurologica dell'Universit\u00e0 di Brescia, Spedali Civili, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.STR.22.11.1452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T21:29:51Z","timestamp":1715549391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.22.11.1452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1991,11]]},"references-count":0,"journal-issue":{"issue":"11","published-print":{"date-parts":[[1991,11]]}},"alternative-id":["10.1161\/01.STR.22.11.1452"],"URL":"https:\/\/doi.org\/10.1161\/01.str.22.11.1452","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1991,11]]},"assertion":[{"value":"1991-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}