Medical Illustrations of Vetebral Artery Strokes
The highest neck area is very different from the five cervical (neck) vertebrae below. Of particular concern is that the vertebral arteries in the back of the neck make a very sharp 90 degree turn as they pass from the top vertebrae to then go to supply the most vital areas of the brain. Cervical manipulation can cause damage to these arteries and lead directly to a stroke or even death.
Highest neck manipulation is not indicated for the philosophical claim that it is effective to awaken the “innate intelligence of the spinal cord” and thereby provide “wellness or health” of the entire body. This top area of the spine does not contain any special “intelligence” as some chiropractors claim. Clearly our intelligence is in our brains above this area.
Manipulation of the vertebrae in the highest neck area can cause trauma (damage) to the blood vessels and tissues in this area. The arterial blood supply to the mentire brain such as the brain stem, cerebellum and the cerebral hemispheres consists of the vertebral arteries in the posterior area (back) of the neck and the carotid arteries in the anterior area (front) of the neck.
Adverse Events from Highest Neck
The trauma to the vertebral and carotid artery usually involves dissection; that is separation between the three layers (inner lining, middle muscle and outer connective tissue) of these arteries. This dissection can be limited to the inner lining, the endothelium or it can extend to the underlying muscular layer and even through the outer connective tissue layer, the adventitia.
Once some degree of dissection occurs, a thrombus (blood clot) can form on the surface of the endothelium or between the layers of these arteries. This thrombus can then become embolic (blood borne) travelling to and occluding the blood supply to various areas of the brain stem, cerebellum and the cerebral hemispheres. Should a dissection extend through the adventitia then a massive haemorrhage would occur. Due to the vital functions of the areas of the brain supplied by these arteries, in particular the brain stem and the cerebellum, a wide variety of strokes with multiple symptoms can result.