What is a Vertebral Artery Dissection?

what is a vertebral artery dissection

Our bodies contain a vast system of blood vessels, veins, and arteries, all of which carry blood to and from the heart. Without adequate blood flow to all parts of the body, we can suffer a wide variety of life-threatening health complications, including death. One type of circulatory complication that has received more medical attention recently is the vertebral artery dissection (VAD), which most commonly results from traumatic accidents. One type of traumatic accident that can cause this injury is chiropractic manipulation. Below, we break down the details of vertebral artery dissections including what they are, what health complications they can lead to, how chiropractic manipulation can cause VAD, and whether or not you can take legal action for VAD.

If you or a loved one has suffered a major injury, illness, or death due to a medical professional’s negligence, you may have grounds to file a medical malpractice lawsuit. Call 312-321-1111 to schedule a free consultation at Curcio & Casciato today.

What are Vertebral Arteries?

Vertebral arteries are large tubes in the neck that carry blood from the heart to the brain and spine. There are two vertebral arteries – the left vertebral artery and the right vertebral artery – that branch off from the aorta in the clavicle area, run through the cervical vertebrae in the neck, and join together at the base of the skull. The combined section of the vertebral arteries is called the basilar artery. All together, these arteries create the vertebrobasilar system.

Carotid Artery vs. Vertebral Artery

You may be confusing the vertebral arteries with the carotid arteries, both of which exist in the neck region. There are two carotid arteries, one on each side of the neck, that also provide blood flow to the neck, face, and brain. The carotid arteries also begin in the chest area and travel up the neck where they separate (or bifurcate) into two other arteries: the internal carotid artery and the external carotid artery. So technically, there are four carotid arteries – two on each side of the neck.

Both the carotid and vertebral arteries play important roles in a healthy circulatory system and central nervous system. According to the Cleveland Clinic, the vertebral arteries provide approximately 20% of blood flow to the brain while the carotid arteries provide approximately 80% of blood flow to the brain.

What is a Vertebral Artery Dissection?

A vertebral artery dissection (VAD) occurs when one or more layers of the artery tear. Meanwhile, a bilateral vertebral artery dissection occurs when one or more layers of both arteries tear. There are three layers of the cervical vertebral artery:

  • Intima: This is the innermost layer of the vertebral artery.
  • Media: This is the middle layer of the vertebral artery that helps blood flow move in the right direction.
  • Adventitia: This is the outer layer of the artery that maintains the artery’s overall structure.

When a cervical arterial dissection occurs, blood will get trapped between the intima and media layers of the artery. This can create a “bulge” in the artery, which disrupts the rest of the blood flow. This is what’s known as a blood clot.

Can a Vertebral Artery Dissection Cause a Stroke?

Yes, the most severe cases of cervical artery dissection (and carotid artery dissection) can lead to a stroke. There are two main types of strokes you can suffer from after a vertebral artery dissection, depending on how many of the artery layers are torn.

  • Ischemic Stroke: This type of stroke occurs when the blood clot in the vertebral artery is so large that it blocks the majority of the blood flow to the brain. Ischemic strokes can also occur if the blood clot breaks off, travels up into the brain, and blocks an artery there.
  • Hemorrhagic Stroke: This type of stroke occurs when all three layers of the vertebral artery tear and, as a result, blood spills out into the neck and never reaches the brain. Sometimes, depending on the location of the dissection, the blood can spill out into the space surrounding the brain. This is called a subarachnoid hemorrhage.

Both types of strokes are life-threatening medical emergencies. If you or a loved one notices the sudden onset of stroke symptoms such as numbness in one side of the body, weakness in the arms or legs, loss of vision in one or both eyes, severe headache, dizziness, loss of coordination, or difficulty speaking, call 911 immediately.

vertebral artery dissection chiropractor

How Does Vertebral Artery Dissection Happen?

Violent and sudden neck movements from cervical spine manipulation therapy, car accidents, slip and fall accidents, or violent assaults are the most common causes of cervical artery dissections. Other less common causes of vertebral artery dissections include:

  • Hyperextending your neck during exercise such as yoga.
  • Lifting heavy weights or objects.
  • Wrestling.
  • Extending your neck for long periods of time (for example: extending your neck for several hours while painting a ceiling).
  • Popping the neck too hard.
  • Receiving CPR.
  • Sneezing, coughing, or blowing your nose too hard.
  • Vomiting.

Vertebral Artery Dissection From Chiropractic Neck Manipulation

Vertebral artery dissections are one of many rare, but well-known complications that can occur during a chiropractic cervical manipulation. Spinal manipulation is a chiropractic treatment in which a chiropractor forcefully pops and realigns sections of the spine. They will typically do this by asking the patient to lay or twist certain ways while they apply force to the spinal column with their hands. In order to realign the cervical spinal joints, the chiropractor will twist the neck certain ways until it pops.

An experienced, board-certified chiropractor knows how to perform spinal manipulation safely. Most of the time, patients do not experience any negative complications from chiropractic spinal manipulation. In fact, a 2015 study states that approximately 1 in 20,000 spinal manipulations resulted in a vertebral artery dissection (although the incidence could be much higher). 60% of chiropractor-related VAD result in subarachnoid hemorrhage.

Chiropractic Malpractice Incident in 2022

There was a very recent case of chiropractic-induced cervical artery dissection that made national news. According to a 2022 report, a Georgia woman suffered a stroke, partial paralysis, and a traumatic brain injury from her chiropractic neck manipulation. It all started with four torn arteries in her neck – so this could mean she tore both vertebral arteries and both carotid arteries.

After her cervical artery dissections, she went into cardiac arrest and suffered a stroke. Her heart stopped for a total of 10 minutes, meaning that blood flow to her brain stopped for 10 minutes. As a result of all of these complications, she suffered a traumatic brain injury and partial paralysis. She survived the incident, but she was left with permanent disabilities. Other news reports state that is actively undergoing multiple types of therapy, including speech, occupational, physical, and recreational therapy.

This is a very rare, worst case scenario of chiropractic malpractice. However, it’s important to remember that there is always a risk of complications from any medical treatment, no matter how skilled the medical professional is.

Risk Factors for Vertebral Artery Dissections

Up to this point, we have discussed what’s called “traumatic vertebral artery dissection,” meaning this type of health complication occurs due to some kind of traumatic accident.

There is also such a thing as “spontaneous vertebral artery dissection,” meaning that this health complication occurs due to seemingly no reason at all. Spontaneous cervical artery dissection is rare, but some people have an increased risk of experiencing this health issue compared to others.

Risk factors include:

  • Ehlers-Danlos syndrome
  • High blood pressure
  • Smoking
  • Cystic medial necrosis
  • Vasculitis
  • Polycystic kidney disease
  • Marfan syndrome
  • Osteogenesis imperfecta

Symptoms of Vertebral Artery Dissection

Symptoms of a traumatic or spontaneous dissection of the vertebral artery include:

  • Poor coordination and balance
  • Neck pain (usually on one side)
  • Severe headache
  • Vertigo
  • Dizziness
  • Hearing loss
  • Double vision (or loss of vision)
  • Difficulty speaking

If you or a loved one has experienced any of these neurological symptoms after cervical manipulative therapy, you may have grounds to contact a Chicago chiropractic malpractice lawyer at Curcio & Casciato.

vertebral artery dissection

Is a Vertebral Artery Dissection Fatal?

Although a vertebral artery dissection is considered a major medical emergency, up to 80% of patients survive and make a full recovery. The risk of death is highest in patients who suffer strokes, subarachnoid hemorrhage, intracranial dissection, and/or brainstem infarction as secondary complications of the original injury.

Treatment for Vertebral Artery Dissection

Once a cervical artery dissection is diagnosed through an angiography or magnetic resonance imaging (or a combination of the two tests called a magnetic resonance angiography), doctors will determine the best treatment method.

If you just suffer an arterial dissection and no stroke or brain hemorrhage, then doctors will allow the dissection to heal on its own. They may provide supportive care, such as anticoagulation treatment, to reduce the risk of blood clots during the healing process.

If you suffer a stroke after your vertebral dissection, doctors may proceed with an endovascular treatment in order to remove a blood clot from the brain. Other possible treatments that doctors may recommend (depending on the severity of your tear and your other complications) include an angioplasty, intracranial stenting, endovascular embolization, or surgery.

Can You Sue for a Vertebral Artery Dissection?

Yes, you can sue for a vertebral artery dissection if it was caused by someone else’s negligence or violence. For example, if you suffered an arterial dissection from a neck manipulation, you may have grounds to file a medical malpractice lawsuit against the negligent chiropractor. In order to build a successful medical malpractice claim, you must prove the 4 D’s of negligence:

  • Duty of Care: All healthcare professionals owe their patients a duty of care to provide safe and competent medical care.
  • Duty Dereliction: The healthcare professional (in this case – a chiropractor) breached this duty of care by committing a negligent action or inaction.
  • Direct Cause: The patient suffered a vertebral artery dissection as a direct result of the chiropractor’s negligence.
  • Damages: The patient suffered a variety of damages as a result of their injury, therefore, they should receive fair compensation.

A Chicago chiropractor malpractice lawyer at Curcio & Casciato can help you prove these 4 elements of negligence through pieces of evidence such as medical records, witness statements, expert medical opinions, and so much more.

Damages for Chiropractor Malpractice

If you have suffered a cervical artery dissection from spinal manipulative therapy, you can receive a settlement that covers all of your damages. Our team of experienced Chicago medical malpractice lawyers can help you obtain financial compensation for all the following types of damages:

  • Past and future medical expenses
  • Past and future rehabilitative expenses
  • Expenses associated with necessary medical equipment (wheelchairs, feeding equipment, voice-activated devices, etc.)
  • Caregiving expenses
  • Lost wages
  • Loss of earning capacity if you suffer a permanent disability which prevents you from doing your job
  • Physical pain and suffering
  • Emotional distress
  • Mental health counseling expenses
  • Loss of consortium
  • Decreased quality of life
  • Average funeral and burial expenses if the cervical artery dissection results in wrongful death
chiropractor vertebral artery dissection

Call Chicago Chiropractic Malpractice Lawyers at Curcio & Casciato Today

Curcio & Casciato is the top medical malpractice law firm in Chicago, IL. Over the years, our experienced legal team has recovered nearly $40,000,000 in combined medical malpractice settlements. We can take on all types of malpractice cases, including chiropractic malpractice, dental malpractice, psychiatric malpractice, birth injuries, surgical errors, medication errors, and so much more. Call 312-321-1111 to schedule a free consultation at our law firm today.

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