that ultimately began this entire process, and she emerged from the photo shoot with a neck pain that in our view was likely the dissection moment for her. There still remains the question of a fall and whether or not she had a fall as part of this entire photo-shoot. There are findings in the autopsy report that suggest that there was a fall. That's contradicted by family and business associates and so on who say there wasn't a fall, but the evidence of the autopsy has a number of aged contusions that would go right back almost to the exact date of the initial neck pain problem. That question I think is still out there to be answered. The exciting part after Dr. Shoshany's answer was that Dr. Oz then turned to a neurologist, a Dr. Brockington, from Mount Sinai Hospital in New York City, and Dr. Brockington made reference to the fact that she sees strokes all day long of all types and that she sees some that have obvious causes. She sees some that don't have any causes at all, and in her world as a specialist focusing on stroke, these are not unusual cases in that spot where she gets to aggregate together all sorts of strokes as a result of her specialty. She even went on to say during the discussion that she had just yesterday or just the day before seen a gentleman who was painting his ceiling overhead at home and had a dissection in the vertebral artery in the process of painting the ceiling, the story we've heard about and we've read about in the literature for decades. She went on to say that these things happen. They happen in seemingly healthy people. They do represent one in four to one in five strokes among middle-aged persons. Even though that number of total strokes is very low, one to four or one to five of those strokes are associated with a cervical artery dissection process. Then she went on to add a very important point that the vast majority of dissections don't end in stroke. Obviously, an even smaller fraction of those that do end in stroke end in fatality. It was a very good commentary, very supportive commentary. Dr. Oz asked her pointblank, did the chiropractor cause this problem, or did the neck manipulation cause this problem, and she answered ... She didn't say yes or no bluntly. She certainly didn't say yes, but she did talk about the fact that the mechanism of this stroke can be varied in terms of its origin and that it is again not at all uncommon in her world among seemingly healthy persons in their middle-aged years to develop this stroke without any activity or problems precipitating it. It just simply happens. In terms of the second question, the follow-up question ... Dr. Brockington went on to demonstrate an angiogram, a magnetic resonance angiography, I believe it was. It might have been a CTA. She talked about the fluid flow and the significance of the fluid flow to the oxygenation of the brain, compared it to basic plumbing in your home and so on and made a good analogy that the public could understand. It was a good illustration to see the processes of the dissection on the imaging so the public could understand what we're talking about in this discussion. The second question went into the history. Very astutely Dr. Shoshany related to Dr. Oz and said that obviously as clinicians we know that the history is really the core of the information that we begin with and often end with in relationship to
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