Intracranial Hypotension Induced by Cervical Chiropraxis

Abstract

Chiropractic care, known for its non-invasive and hands-on approach to healthcare, can occasionally lead to adverse reactions. This case report details an unusual occurrence of intracranial hypotension (IH) in a 30-year-old female who received chiropractic care for neck pain. The patient experienced a throbbing positional headache five days after mobilization and adjustment of the cervical spine. Upon admission, lumbar puncture performed in the lateral position revealed an opening pressure of 55 mm H2O. Magnetic resonance imaging showed subdural fluid collection and diffuse pachymeningeal enhancement in the cerebral hemispheres. Radioisotope cisternography revealed dural leakage at the upper cervical level. Following unsuccessful supportive measures, the patient underwent treatment with an epidural blood patch. After the treatment, her postural headaches completely subsided without recurrence. This report underscores that IH syndrome is a rare yet clinically significant complication that may be associated with manipulation of the upper spine.