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Spinal Fluid Leak After Chiropractic Manipulation of the Cervical Spine
Arch Ophthalmol. 2006;124:283.
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Intracranial hypotension (ICH) caused by cerebrospinal fluid (CSF) leakage is a well-documented cause of severe headaches and neurologic deficits. Cerebrospinal fluid leaks most often occur as a complication of neurosurgical procedures, in particular lumbar puncture, or after accidental trauma.
Report of a Case
A 51-year-old woman had binocular horizontal diplopia for 4 weeks. She reported having headaches for several weeks, which had been treated by her chiropractor. After receiving cervical spinal manipulation on 3 separate occasions, she did not experience relief but instead escalation of the headache. One week after the last chiropractic treatment, she developed binocular horizontal diplopia prompting neuro-ophthalmic evaluation. Her visual function and ocular fundus were normal. Ocular motility testing revealed a right cranial nerve VI palsy with a 20–prism diopter (PD) esotropia (ET) in primary gaze, upgaze, and downgaze; 35-PD ET in right gaze; and 1-PD ET in left gaze. Magnetic resonance imaging showed diffuse enhancement of the meninges and . . . [Full Text of this Article]
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AUTHOR INFORMATION
Michaela K. Mathews, MD;
Larry Frohman, MD;
Huey-Jen Lee, MD;
Robert C. Sergott, MD;
Peter J. Savino, MD
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