Abstract
Background Despite widespread utilization of chiropractic treatment for various ailments, there
is a paucity of documentation regarding intracerebral hemorrhage related to chiropractic
trauma. Stroke has been reported from cervical manipulation, although with a suggested
low incidence. Activator treatment, an instrument that produces a high-velocity, low-amplitude
impact to the spine, is considered especially safe. There are no prior reports of
intracerebral hemorrhage resulting from a chiropractic activator treatment.
Case Description A 75-year-old woman was admitted to the hospital with a history of headaches, visual
difficulties on the right, and speech disturbance of relatively acute onset. CT scan
showed a brain hemorrhage in an unusual location. Extensive evaluation was undertaken
because this was thought to be a spontaneous event. No cause was found on imaging.
Subsequent history revealed a chiropractic activator treatment applied directly to
the junction of the back of her head and the upper cervical spine immediately prior
to the onset of symptoms. Her clinical course is described.
Conclusions This appears to be the first report linking traumatic intracerebral hemorrhage with
a chiropractic activator treatment. The use of this modality in an elderly population,
with widespread utilization of anticoagulants and platelet inhibitors, is of potential
concern.
Keywords
activator - chiropractic - stroke - trauma - cerebral hemorrhage
