Putting The Stroke Issue to Bed

neck adjusted or not. Part of that is based on your communication skills and your education with those patients of yours and your community. I just didn't know if you had anything you wanted to reiterate or bring forward based on what we've now learned, even including about the autopsy or anything else, Dr. Clum. Thanks, Stu. It's important, and I think it's important to go back to a position that Dr. Shoshany expressed to Dr. Oz, and it is absolutely factual. The science is on our side in this discussion. As you said, the evidence is there. If you as a chiropractor are not familiar with the Cassidy Study from 2008, the Kosloff Study from 2015 and the Church Study from 2016, you are shortchanging yourself, so please, please, please, get those studies, read them very carefully, be familiar with them. They are your best friends in this discussion. It's great data. It's great science, and it's information that you should put to work for you. The other consideration that Stu was talking about is now that we have more information in terms of the autopsy report, to me, for my nickel, reading it, it's very clear that the coroner did not view ... I'm sure the gentleman was thorough and competent. I don't mean to cast any aspersions in that regard, but what I am suggesting is that he's never seen one of these cases before, by his own admission, and that when he did see one, he jumped for a piece of literature that paralleled the case he had on the table, and he brought that into his report, and it was a 2007 study that was a single case report. The problem with that is, a case report is the lowest form of evidence that we can offer. Number two, there are case control and case cross-over studies and now even meta-analyses that speak to the very science that we're talking about that contradict that case study. Number three, the case study the coroner brought forward didn't have a dissection on imaging and didn't demonstrate a dissection or discuss a dissection on autopsy. Then this was brought forward as the evidence to substantiate his conclusion that the chiropractor was the cause of this bilateral vertebral artery dissection. The next factor to keep in mind is that ... This is a criticism of the coroner. He frankly misquoted the literature and made reference to an incident associated with bilateral dissection of the vertebral artery that was just simply wrong. It was an error on his part. Then the last consideration to make, and perhaps one of the most important, is to understand that bilateral dissection is generally associated with arteriopathy, that there is a fault in the structure that allows that person to dissect bilaterally. It's beyond the pale to think that the forces involved, even though the literature says they're fractional of what's necessary to damage an artery, but to suggest that the bilateral is the product of forces, generally speaking, bilateral dissections are associated with arteriopathy and underlying histological weakness in the vessel that eventually comes to a point, and it did in the situation of Katie May, in my opinion.

Dr. Clum:

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