Evidence map›Paper›PMID 41915227›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026

Pediatric vertebral artery dissection and ischemic stroke following chiropractic manipulation.

Jonathan C Arnold, Andrew M Brumett, Kyle J Ortiz Rodriguez, Raj Swaroop Lavadi, Rabia Qaiser

Abstract readCase Reports
In one paragraph

Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Clarifying causality and reporting in pediatric vertebral artery dissection.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jonathan C ArnoldDepartment of Neurological Surgery, Indiana University School of Medicine, 355 West 16th Street, Goodman Hall 5100, Indianapolis, IN, 46202, USA.
Andrew M BrumettDepartment of Neurological Surgery, Indiana University School of Medicine, 355 West 16th Street, Goodman Hall 5100, Indianapolis, IN, 46202, USA.
Kyle J Ortiz RodriguezDepartment of Neurological Surgery, Indiana University School of Medicine, 355 West 16th Street, Goodman Hall 5100, Indianapolis, IN, 46202, USA.
Raj Swaroop LavadiDepartment of Neurological Surgery, Indiana University School of Medicine, 355 West 16th Street, Goodman Hall 5100, Indianapolis, IN, 46202, USA. rslavadi@iu.edu.
Rabia QaiserDepartment of Neurological Surgery, Indiana University School of Medicine, 355 West 16th Street, Goodman Hall 5100, Indianapolis, IN, 46202, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pediatric vertebral artery dissection (VAD) following chiropractic cervical manipulation (CCM) is a rare phenomenon. As chiropractic care of pediatric populations increases internationally, it is imperative to increase awareness of this cause of VAD. The patient encountered in our institution was a 20-month-old male who presented nonspecifically with acute onset of lethargy, vomiting, cyanosis, and respiratory distress. Cerebrovascular imaging revealed a luminal irregularity in the V4 segment of the right vertebral artery, consistent with dissection. The patient's guardian later provided history of taking the child for cervical chiropractic corrections immediately prior to the patient's presentation to the emergency department. The patient was managed non operatively and was later discharged without neurological deficit. Non-specific presentations were also noted in the other two cases described in the literature. Appropriate diagnosis of pediatric VAD requires increased surveillance in response to a thorough history and an acknowledgment of the plethora of possible patient presentations and etiologies.

Indexed as

Ischemic StrokeManipulation, ChiropracticVertebral Artery DissectionHumansInfantMaleCervical manipulationChiropractorPediatricStrokeVertebral artery dissection

Identifiers

PMID41915227
PMCPMC13038740

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.