Chiropractic Referral for Computed-Tomography Angiography to Rule Out Vertebral Artery Dissection: A Case Report

Abstract

Objective: This paper describes a case of chiropractic referral to medical emergency services for computed-tomography angiography (CTA) imaging to rule out vertebral artery dissection (VAD).

Clinical Features: A 50-year-old female presented to a chiropractic physician with an idiopathic onset of neck pain, headache, nausea, and dizziness. Differential diagnosis included VAD, internal carotid artery dissection (ICAD), as well as cerebral aneurysm or other intracranial abnormality. Due to symptoms of potential VAD, the patient was referred to medical emergency services for CTA imaging to rule out VAD. CTA revealed a possible posterior communicating artery (PCom) aneurysm vs. infundibulum, and left C3-C4 facet arthropathy. No VAD was noted.