eTalks #7 - Cervical arterial dissection: recognition and implications for practice

Craniocervical arterial dissection is a common cause of stroke in young people which in rare cases been associated with cervical manipulative therapy. The mechanism is considered to involve pre-existing arterial susceptibility and a precipitating event. Pre-manipulative screening tests are limited in their ability to identify those at risk. In particular one difficulty is that the early features of CAD can mimic a painful musculoskeletal presentation and a patient may present for treatment of neck pain and headache with a dissection in progress. Identification of individuals at risk, or early recognition of a dissection in progress, could help expedite medical intervention and avoid inappropriate treatment.

This eTalk will focus on the aetiology, pathophysiology and clinical features of dissection to assist clinicians to identify risk factors and early clinical presentation of patients with craniocervical arterial dissection, in order to improve the timely identification of this often difficult to diagnose condition.

Presenter

Dr Lucy Thomas is a lecturer at the University of Queensland and a conjoint lecturer at the University of Newcastle. She is a practicing physiotherapist with post-graduate qualifications in manipulative physiotherapy, a Master of Medical Science (Physiotherapy) and completed her PhD “Minimising Risk Factors for Cervical Spine Manipulation in 2013. Her main research focus is on improving screening practices in cervical manipulative therapy, in particular understanding the risk factors and early recognition of craniocervical arterial dissection.

Dr Thomas is currently chairing a working party reviewing the Australian Physiotherapy Association (2006) Guidelines for assessing Vertebrobasilar Insufficiency. Current research projects include the investigation of risk factors such as seasonal variation and minor trauma in patients with cervical arterial dissection and well as experimental imaging studies examining the effect of neck position on the mechanical properties of the cervical artery wall.

CPD Hours

1 hour