Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck

B L Parwar; A A Fawzi; A C Arnold; S D Schwartz

doi:10.1016/s0002-9394(00)00829-1

Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck

Am J Ophthalmol. 2001 Apr;131(4):523-4. doi: 10.1016/s0002-9394(00)00829-1.

Authors

B L Parwar¹, A A Fawzi, A C Arnold, S D Schwartz

Affiliation

¹ Jules Stein Eye Institute, University of California, Los Angeles, California 90095-7000, USA.

PMID: 11292428
DOI: 10.1016/s0002-9394(00)00829-1

Abstract

Purpose: To report a case of Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck.

Methods: Case report. A 44-year-old woman with no prior ocular or vascular history presented with severe right-sided head and neck pain, ptosis, and miosis following chiropractic treatment for a strained right shoulder muscle.

Results: Magnetic resonance angiography of the neck and brain revealed a dissection of the right internal carotid artery as well as a suggestion of subtle dissection in the right vertebral artery. No significant brain abnormalities were noted on magnetic resonance imaging. Pharmacological testing was consistent with preganglionic oculosympathetic damage.

Conclusion: Acute, painful Horner's syndrome as a manifestation of vascular dissection may be associated with chiropractic manipulation of the neck.

Publication types

Case Reports

MeSH terms

Adult
Blepharoptosis / etiology
Carotid Artery, Internal / pathology
Carotid Artery, Internal, Dissection / diagnosis
Carotid Artery, Internal, Dissection / etiology*
Female
Headache / etiology
Horner Syndrome / diagnosis
Horner Syndrome / etiology*
Humans
Magnetic Resonance Imaging
Manipulation, Spinal / adverse effects*
Miosis / etiology
Neck
Neck Pain / etiology