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In these cases, a patient comes in already experiencing a stroke. The chiropractor adjusts the neck. The patient then immediately experiences more severe stroke symptoms. In cases where the symptoms that the patient presents with are not clearly stroke symptoms (simply headache and neck pain), these cases are typically defensible, so long as there is a signed Informed Consent and the chiropractor then calls 911 and gets the patient to the hospital. In cases where the patient was more clearly experiencing stroke symptoms and the chiropractor fails to recognize the symptoms and still provides an adjustment, these cases can be hard to defend. Let’s look at some of the facts and figures of the circumstances of arterial dissection related stroke as well as some of the most current literature on the subject:

Stroke in the U.S. Population: In General

Washington Post, June 16, 2014 “Strokes, long on the decline in the elderly, are rising in the younger population”

Stroke in the U.S. Population: Specific to Chiropractic

Current Emergency Room (ER) protocols involve questioning all stroke and possible stroke patients about any chiropractic care they may have received. This will yield a distorted response as many, many people who have strokes have seen a chiropractor.

Best Available Data

750,000 strokes occur in the U.S. annually. Strokes arising from dissection of a verterbal artery occur at a rate of 1 per 133,000 population. If there are 315 million people in the U.S. we can expect 2,368 of these strokes to occur each year. This means we are not associated in anyone’s mind with 747,632 of 750,000 strokes annually in the U.S. (750,000-2,368=747,632). If 10% of the U.S. population seeks chiropractic care annually then we could anticipate 237 of these strokes to cross the path of a chiropractor. If we estimate that there are 65,000 chiropractors practicing in the U.S. then 1 in 275 chiropractors may have this situation present in their offices. It is estimated that one vertebral artery related stroke is associated with every 1-2 million cervical spinal adjustments. Persons who experience a vertebral artery dissection related stroke make a good recovery 75% of the time and the stroke is fatal 5% of the time. Therefore one fatality could be expected to be associated with every 20-40 million cervical spine adjustments. Many things in life are associated with one another, that does not mean there is a cause and effect relationship between them. For example, firemen are associated with house fires but firemen don’t cause house fires. Similarly chiropractic care is associated with vertebral artery dissection related stroke, but, it has not been established that chiropractic cervical spine adjustments are causing vertebral artery related dissections and strokes. Association versus Causation:

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