CLINICAL FEATURES: A 49-year-old man with non-traumatic chronic episodic head and neck pain presented for care. Examination and plain film radiographs were unremarkable, suggesting a mechanical origin for the symptoms; however, information in the case history raised concerns.
INTERVENTION AND OUTCOME: The patient was examined and not manipulated by the doctor of chiropractic but referred back to his general practitioner for a second opinion. The following week, the patient was admitted to hospital having had a cerebrovascular accident.
CONCLUSION: The possible indication of the prodrome to a stroke may lie in the case history rather than the examination findings and provocative testing.
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