This report describes her presentation, the evolution of her imaging studies, and her outcome. The current literature on activator treatment and complications appeared to be sparse on complications in general and nonexistent specifically on a complication of this type. This led to a fairly extensive workup, in part because initially there was no history of any conventional trauma, and this was first considered a spontaneous hemorrhage. Several experienced and senior neurosurgeons caring for her considered this an unusual location for a hemorrhage of this type, regardless of cause, and certainly not from any of the usual causes or types of trauma routinely associated with a busy and active emergency room and trauma service.

A subsequent CT scan of the brain without contrast showed a hemorrhage with acute characteristics consistent with the time from the treatment and very localized in this precise location. The use of this modality in an elderly population, with widespread utilization of anticoagulants and platelet inhibitors, is of potential concern.Īn elderly but very active woman with a long history of pain complaints, including neck pain, and prior chiropractic adjustments, developed a headache-based acute illness with speech and visual complaints shortly after the application of an activator treatment in which the instrument was directed by the chiropractor at the base of her skull on the left side.

Her clinical course is described.Ĭonclusions This appears to be the first report linking traumatic intracerebral hemorrhage with a chiropractic activator treatment. Subsequent history revealed a chiropractic activator treatment applied directly to the junction of the back of her head and the upper cervical spine immediately prior to the onset of symptoms. Extensive evaluation was undertaken because this was thought to be a spontaneous event. CT scan showed a brain hemorrhage in an unusual location. There are no prior reports of intracerebral hemorrhage resulting from a chiropractic activator treatment.Ĭase Description A 75-year-old woman was admitted to the hospital with a history of headaches, visual difficulties on the right, and speech disturbance of relatively acute onset. Activator treatment, an instrument that produces a high-velocity, low-amplitude impact to the spine, is considered especially safe. Stroke has been reported from cervical manipulation, although with a suggested low incidence. Background Despite widespread utilization of chiropractic treatment for various ailments, there is a paucity of documentation regarding intracerebral hemorrhage related to chiropractic trauma.

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