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Case Reports
. 2020 Aug;42(6):e518-e520.
doi: 10.1097/MPH.0000000000001559.

Recurrent Stroke in a Child With Atlantoaxial Instability Following Chiropractic Manipulation

Majd T Ghanim  1 , Shayla Bergmann  1 , Raymond D Turner  2 , Ramin Eskandari  2 , Arash Mahajerin  3
Affiliations
Case Reports

Recurrent Stroke in a Child With Atlantoaxial Instability Following Chiropractic Manipulation

Majd T Ghanim et al. J Pediatr Hematol Oncol. 2020 Aug.

Abstract

Pediatric stroke presents with a variety of signs and symptoms. Correct modality of imaging is essential in decreasing the time from symptom onset to appropriate management. Evaluation of pediatric stroke should include both blood work as well as imaging in a parallel rather than a sequential matter. We report a case of a child with a bow hunter's stroke that was challenging to diagnose. This type of stroke happens when the vertebral artery is occluded at the atlantoaxial or subaxial level during neck rotation. This case demonstrates that workup of stroke should be comprehensive to include all mechanical and anatomic possibilities before investigating rarer hypercoagulable disorders.

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