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NEUROLOGY 1989;39:512
© 1989 American Academy of Neurology

Dissecting aneurysm of the vertebral artery and cervical manipulation

A case report with autopsy

J. L. Mas, MD, D. Henin, MD, M. G. Bousser, MD, F. Chain, MD and J. J. Hauw, MD

Sevice de Neurologic, Centre Raymond Garcin, CHS Sainte-Anne, Höspital de la Salpëtrière, Paris, France (Dr. Mas)
Laboratoire de Neuropatholcgie R. Escourolle, Höspital de la Salpëtrière, Paris, France (Dra. Henin and Hauw)
Clinique den Maladies du Système Nerveux, Höspital de la Salpëtrière, Paris, France (Drs. Bousser and Chain).

A 35-year-old woman with 3 weeks of cervical pain developed ischemia in the badar artery temtory following cervical manipulation. At autopsy, there was a dissecting aneurysm within the third segment of the right vertebral artery. The pathologic changes in the lower and the upper part of the dissecting aneurysm were Me rent, indicating recurring bleeding. Cervical manipulation could have accounted for one recent dissection, but not for another, which was a few weeks old. This suggests that cervical pain, which prompted the manipulation, may have been the first symptom of the dissection, and manipulation of the neck precipitated the stroke by inducing bleeding within the dissecting aneurysm.

Address correspondence and reprint request a to Dr. Mas, Service de Neurologic. Centre Raymond Garcon. CHS Sainte-Anne, 1 rue Cabanas, 75674 Paris Codex 14. France.

Received September 19, 1988. Accepted for publication in final form October 28, 1988.




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