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“Risk of Vertebrobasilar Stroke and Chiropractic Care”, Cassidy et al. SPINE Volume 33, Number 45, pages: S176-S183 “Because the association between chiropractic care and VBA stroke is not greater than the association between PCP visits and VBA stroke there is no excess risk of VBA stroke from chiropractic care.” “We have not ruled out neck manipulation as a potential cause of some VBA strokes. On the other hand it is unlikely to be a major cause of these rare events. Our results suggest that the association between chiropractic care and VBA stroke found in previous studies is likely explained by presenting symptoms attributable to vertebral artery dissection.” Cassidy and associates compared the rate of vertebral artery related stroke among patients who had recently seen their primary medical provider and compared the rate of vertebral artery stroke among patients who recently saw a chiropractor. The discussion assumes the primary medical provider is not providing cervical spine adjustments and that the chiropractor is. In this situation there was no greater incidence of strokes among patients who had seen a chiropractor versus a primary medical provider. Therefore it was reasoned that there is nothing that the chiropractor is doing that increases the rate of occurrence of vertebral artery dissection related stroke. The table below compares patients of chiropractors versus primary medical care providers, compares them if they presented with neck pain or headache (symptoms of vertebral artery dissection) and compares them based on being above or below age 45. The odds of chiropractic care being associated with a vertebral artery stroke did not exceed the odds of a primary medical care visit being associated with such a stroke in five of the six data sets. In the 6 th the difference was statistically insignificant. (The lower the number, the lower the odds)

“Etiology of Cervical Artery Dissection: The writing is in the wall”, Schievink, Neurology 2011;76;1452

“…it is not the intimal layer but rather the media and adventitia that are primarily affected in cervical artery dissection…(these findings) confirm the existence of an underlying systemic

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