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Quick response key after chiropractic-related stroke

Dec. 1, 2016, 10:04 AM

Ashley Johnson suffered the same type of stroke after a chiropractic neck manipulation that killed model and social media star Katie May earlier this year, but the 29-year-old woman survived thanks to quick recognition and rapid response.

Ashley Johnson
Ashley Johnson

The Spring Hill, Tennessee, chiropractor’s office, where Johnson had been going for pain management treatments, dialed 911 when she reported being dizzy and having double vision. Spring Hill Emergency Services had her airlifted to Vanderbilt University Medical Center (VUMC).

A team at the Vanderbilt Stroke Center administered tPA to dissolve Johnson’s blood clot before it could do permanent brain damage.

The stroke resulted from a vertebral artery dissection after a neck manipulation, said Lisa Hermann, M.D., the Vanderbilt neurologist who treated her. The exact incidence of the potentially deadly complication from the chiropractic procedure is unknown and estimates vary.

Herman praised Spring Hill Emergency Services for recognizing the need to have Johnson airlifted.

“This is the perfect situation,” Hermann said. “Every member of the team functioned as they were supposed to. Because of that, we had an excellent result.”

A team, including neurosurgeons, was on standby awaiting Johnson’s arrival.

“We were waiting for her when she hit the door,” Hermann said. “We were able to dissolve the clot with tPA, but if she had needed an acute cerebrovascular intervention or an acute thrombectomy by one of our interventionists, she would have gotten that nearly as quickly.”

Johnson was back at home in a couple of days with her 3-year-old son.

“Everybody from A to Z helped save my life,” she said, thanking the emergency responders for making the decision to have her airlifted to VUMC.

Kiersten Espaillat, DNP, stroke coordinator for the Vanderbilt Stroke Center, said strokes can be missed in younger people, delaying medical interventions that can save lives and prevent permanent brain damage.

“Young, otherwise healthy women, are not what come to mind with the word ‘stroke,’” Espaillat said. “This case highlights the importance of recognizing symptoms, calling for EMS support and rapidly transporting to a stroke center for definitive care. As a community, as a team, each member had a role in saving Ashley’s life.”

Johnson, a Columbia, Tennessee, resident who sought chiropractic treatments to avoid having to take pain medications, said she never considered the possibility of a stroke.
The symptoms from a vertebral artery dissection started immediately after the neck manipulation.

Johnson suffered her stroke Oct. 26, a week after news broke that the Los Angeles County Medical Examiner’s office had ruled that May’s Feb. 4 death was due to a stroke caused by a chiropractic neck manipulation. She was 34.

“I guess the difference between me and the social media celebrity is that she went home. She didn’t seek medical help,” Johnson said. “There is no way that I could have gotten to the car to drive home.”

VUMC is a Joint Commission-certified Advanced Comprehensive Stroke Center, the highest certification level given. The Vanderbilt Stroke Center rapid response for treating stroke patients has received the American Stroke Association’s Honor Roll-Elite Plus recognition.

This designation is given in recognition for performance beyond the requirements for the American Stroke Association’s Gold Plus Quality Achievement Award.

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