TAILIEUCHUNG - Báo cáo y học: "Current understanding of the relationship between cervical manipulation and stroke: what does it mean for the chiropractic profession"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Current understanding of the relationship between cervical manipulation and stroke: what does it mean for the chiropractic profession? | Murphy Chiropractic Osteopathy 2010 18 22 http content 18 1 22 CHIROPRACTIC OSTEOPATHY COMMENTARY Open Access Current understanding of the relationship between cervical manipulation and stroke what does it mean for the chiropractic profession Donald R Murphy1 2 3 Abstract The understanding of the relationship between cervical manipulative therapy CMT and vertebral artery dissection and stroke VADS has evolved considerably over the years. In the beginning the relationship was seen as simple cause-effect in which CMT was seen to cause VADS in certain susceptible individuals. This was perceived as extremely rare by chiropractic physicians but as far more common by neurologists and others. Recent evidence has clarified the relationship considerably and suggests that the relationship is not causal but that patients with VADS often have initial symptoms which cause them to seek care from a chiropractic physician and have a stroke some time after independent of the chiropractic visit. This new understanding has shifted the focus for the chiropractic physician from one of attempting to screen for risk of complication to manipulation to one of recognizing the patient who may be having VADS so that early diagnosis and intervention can be pursued. In addition this new understanding presents the chiropractic profession with an opportunity to change the conversation about CMT and VADS by taking a proactive public health approach to this uncommon but potentially devastating disorder. Introduction Cervical manipulative therapy CMT and vertebral artery dissection and stroke VADS have been linked in controversy for at least 75 years 1 . At the center of the controversy have been neurologists and other medical practitioners who have often perceived VADS to be a relatively frequent complication to CMT 2 3 and chiropractors who have generally perceived VADS after manipulation to be exceedingly rare 4-6 . Others have been involved as well 7 8 . Starting with .

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