Intracranial hypotension induced by cervical spine chiropractic manipulation.

Sang-Il Suh, Seong Beom Koh, Eun Jung Choi, Byung Jo Kim, Min Kyu Park, Kun Woo Park, Joon Shik Yoon, Dae Hie Lee

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

STUDY DESIGN: Case report. OBJECTIVES: We report a case of intracranial hypotension ensuing after a spinal chiropractic manipulation leading to cerebrospinal fluid (CSF) isodense effusion in the upper cervical and thoracic spine. SUMMARY OF BACKGROUND DATA: The etiology of intracranial hypotension is not fully understood, but CSF leakage from spinal meningeal diverticula or dural tears may be involved. METHODS: A 36-year-old woman presented with neck and both shoulder pain 4 days earlier. She undertook a spinal chiropractic manipulation. After this maneuver, she complained of a throbbing headache with nausea and vomiting. Her headache worsened, and lying down gave the only measure of limited relief. In CSF study, it showed dry tapping. Brain MRI showed pachymeningeal gadolinum enhancement. Thoracic spine MRI showed CSF leakage. After admission to the hospital, she was treated by hydration and pain control over several days. However, her headache did not improve. RESULTS: She was treated by epidural blood patch. Afterwards, her headache was improved. This is the first case of spontaneous intracranial hypotension in which spinal chiropractic manipulation coincided with the development of symptoms and in which a CSF collection in the upper cervical and thoracic spine was demonstrated radiographically in Korea. CONCLUSIONS: From this case, we can understand the etiology of intracranial hypotension and consider the complication of chiropractic manipulation.

Original languageEnglish
JournalSpine.
Volume30
Issue number12
Publication statusPublished - 2005 Jun 15

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Chiropractic Manipulation
Intracranial Hypotension
Spinal Manipulation
Headache
Spine
Cerebrospinal Fluid
Thorax
Epidural Blood Patch
Shoulder Pain
Diverticulum
Korea
Tears
Nausea
Vomiting
Neck
Pain
Brain

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Intracranial hypotension induced by cervical spine chiropractic manipulation. / Suh, Sang-Il; Koh, Seong Beom; Choi, Eun Jung; Kim, Byung Jo; Park, Min Kyu; Park, Kun Woo; Yoon, Joon Shik; Lee, Dae Hie.

In: Spine., Vol. 30, No. 12, 15.06.2005.

Research output: Contribution to journalArticle

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AU - Choi, Eun Jung

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AU - Park, Kun Woo

AU - Yoon, Joon Shik

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