Although most people who suffer strokes are older, stroke can occur at any age. Especially prone to stroke are people with unhealthy lifestyles those who smoke, stick to poor diets, and don’t exercise. Stroke is also associated with people who suffer from obesity, high blood pressure, heart disease, alcohol abuse, diabetes, or have a family history of stroke or an abnormal heart rhythm. Women who use oral contraceptives have a higher stroke risk incidence. African-Americans also have a much higher incidence of stroke. In the United States, strokes are the most common cause of disability and the third most common cause of death in adults.

What Is Stroke?

Stroke is caused by a lack of blood supply to a portion of the brain, which causes that portion to die within just a few minutes. This lack of blood supply, also known as ischemia, results in long-term neurological effects because the cells in the brain do not regenerate. The outcome of stroke depends on the person’s age, general health, the region of the brain affected by the stroke, the type of stroke, and the extent of the brain damage. Common long-term effects include difficulty speaking, poor memory, altered emotions, poor recognition of previously familiar objects and people, amnesia, deformities of the extremities, and difficulty with movement, including weakness and paralysis. The weakness and paralysis often affect one side of the body—usually opposite the stroke location. Some of the effects can be permanent, while others may resolve with time and treatment.

What Are the Warning Signs of Stroke?

Sometimes people experience a “pre-stroke”—a short term lack of blood supply to the brain, also called a transient ischemic attack. The loss of blood supply lasts from seconds to just a few minutes and does not result in permanent damage. This condition is often a precursor to a full-scale stroke, so any symptoms associated with it should be investigated immediately.


Recognizing a Stroke


Remember the “3” steps, STR . Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.

T *Ask the person to TALK, to SPEAK A SIMPLE SENTENCE
(Coherently) (i.e. . . It is sunny out today)

R *Ask him or her to RAISE BOTH ARMS.

{NOTE: Another ‘sign’ of a stroke is this: Ask the person to ‘stick’ out their tongue… if the tongue is ‘crooked’, if it goes to one side or the other that is also an indication of a stroke}


What Should I Do If I Have Any of the Symptoms?

If you, your friend, or a family member is having any symptoms, seek medical care immediately:

• Dial 911 or have someone take you or your friend to the nearest emergency room.  Do NOT let the person with the symptoms drive or stay home.

• Try to remember the time of onset of your symptoms and what symptoms you’re having. This information will help the treating doctors provide the best possible care for you.


The sooner you seek emergency medical assistance, the better the chances of minimizing the damage from a stroke. The person with the symptom should seek medical care even if:

• Not all symptoms are present.

• The symptoms go away after a short time.

• He or she has the symptoms with no real pain.

• He or she denies the symptoms.


What Is the Treatment for Stroke?

There are generally three separate stages of treatment for stroke: prevention, therapy immediately after stroke, and post-stroke rehabilitation. Stroke prevention is based on treating underlying risk factors (see tips below). Acute stroke therapies try to stop a stroke while it is happening. These include anti

coagulants that help break up or prevent further formation of blood clots and efforts to support the person’s vital functions, such as breathing. Post-stroke rehabilitation helps overcome some of the disabilities that result from the brain damage. For most stroke patients, physical therapy, occupational therapy, and speech therapy form the base of a rehabilitation program.

How Can I Reduce My Risk of a Stroke?

1. Stop smoking.  In some people, smoking cessation can reduce the risk of a stroke to that of a non-smoker.  Smoking causes damage to the blood vessels throughout the body. Some of the chemicals in tobacco smoke take the place of oxygen in the blood, increasing the likelihood of loss of blood supply to the brain.

2. Eat a healthy diet.  Eat only sensible portions of foods. Avoid foods high in saturated and trans fats.

3. Keep your blood pressure under control.

4. Get regular physical examinations and follow your doctor’s orders.

Is There Risk of Stroke from Neck Manipulation?

Skilled cervical spine joint manipulation and mobilization are now established as safe, effective and appropriate treatments for patients with the most common forms of neck pain and cervicogenic headache, alone or in combination with exercises and soft tissue therapies.

According to the 2010 Task Force on Neck Pain and its Associated Disorders “therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain.”[i] This opinion was recently reiterated in the Evidence-Based Guidelines for Chiropractic Treatment of Adults with Neck Pain.[ii] This latest guidelines also pointed out that while medication offers some immediate pain relief, it is not as effective as manual therapies and exercise in improving function, as well as pain relief.

Vertebrobasilar stroke (VBS) following neck manipulation by a health professional is extremely rare. Responsible estimates of the risk rate varied between 1 in 400,000 and 1 in 5.85 million treatments.[iii] The figure most frequently given by experts is 1 in every 1 to 2 million treatments. This risk rate can probably be better understood when described as one incidence in a group of 25 chiropractors all of whom have practiced for 40 years.

A multifactorial model of risk for stroke involves 4 necessary elements, including genetic predisposition; environmental exposure, e.g. infection or oral contraception use; trivial trauma and atherosclerosis risk factors, e.g. hypertension, diabetes mellitus and smoking. Therefore, VBS is rare because the patient must have both an underlying predisposition in one or more necessary triggers.

With this in mind, the scientific literature has now established cervical spine manipulation as a safe, effective and appropriate treatment for patients with both acute and chronic neck pain.


[i] Haldeman S,Carroll LJ, Cassidy JD et al. (2008) Best Evidence Synthesis on Neck Pain: Findings from the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine 33 (4S):S1-S220.

[ii] Bryans R, Decina P et al. (2014) Evidence-Based Guidelines for Chiropractic Treatment of Adults with Neck Pain J Manipulative Physiol Ther 37: 42-63. He

[iii] Haldeman S, Kohlbeck FJ, McGregor M  (2001) Unpredictability of Cerebrovascular Ischemia Associated with Cervical Spine Manipulation Therapy: A Review of 64 Cases after Cervical Spine Manipulation, Spine 27(1):49-55.