Abstract: ObjectiveTo describe 64 cases of cerebrovascular accidents temporally associated with cervical vertebra manipulation therapy in terms of patients' characteristics, potential risk factors, nature of complication, and neurologic sequelae.MethodsThree researchers using a uniform data abstraction instrument performed an independent review of 64 previously medicine records describing cerebrovascular ischemia after cervical vertebra manipulation. Descriptive statistics were calculated for characteristics of the patients and the complications. Means and standard deviations were computed for continuous variables. Frequencies were computed for continuous variables. Frequencies and proportions were calculated for categorical variables.ResultsProposed risk factors include age, gender, migraine headaches, hypertension, diabetes, birth control pills, cervical spondylosis, and smoking. It was unable to identify factors from the clinical history and physical examination of the patient that would assist a physician attempting to isolate the patient at risk of cerebral ischemia after cervical manipulation.ConclusionsCerebrovascular accident after manipulation appear to be unpredictable and should be considered an inherent, idiosyncratic, and rare complication of this treatment approach.

Key words: cerebrovascular accidents, manipulation therapy, complication