NECK MOBILIZATION AND STROKE AT 30 YEARS OLD, WHEN ALTERNATIVE MEDICINE IS A PROBLEM - CASE REPORT

Introduction and objective The incidence of stroke caused by cervical manipulation ranges from one in 400.000 to one in 5.8 million. However, no consideration is given to the possibility that many strokes caused by neck manipulation may go unreported. We aim to present a case of a stroke after spinal mobilization. Methods Interviews and clinical file consulting. Results and Conclusion A 30 years old female, from a nuclear family, functional APGAR, Duvall’s stage 1, followed by her family doctor for birth control, hirsutism treatment and by occasional lumbago, medicated with combined oral contraceptive and diclofenac in SOS, started with neck pain after flexion movement. After ~10 days she booked an alternative medicine consultation (osteopathy/homeopathy). During cervical manipulation, by the osteopathy practitioner, the patient felt the following symptoms: dizziness, vomiting, vision impairment and loss of neck muscular strength. The emergency number was called and the patient was carried to the local hospital. At the hospital the patient was diagnosed with anterior inferior cerebellar artery embolic stroke and a right vertebral artery lesion, suggestive of a translating dissecting mechanism. Patient is medicated with warfarin. After a stroke and along warfarin treatment, this patient could not keep the same medication and has an increased risk of another stroke at long-term. Moreover, is possible she still looks for alternative medicine, as alimentary supplements/teas, which could undergo warfarin interaction. The difficulty explaining patients the risk of non-evidence based practices is increased for family doctors; however is present more than ever in every day consultation.