A case study utilizing spinal manipulation and dynamic neuromuscular stabilization care to enhance function of a post cerebrovascular accident patient.

INTRODUCTION: This case report demonstrated physical function improvement of a 31-year-old male, four years post cerebral vascular compromise, with 32 weeks of Chiropractic adjustive and Dynamic Neuromuscular Stabilization (DNS) rehabilitation care. METHODS: Chiropractic care occurred weekly over a 32 week care program with the inclusion of DNS treatments over the final 16 weeks. Functional changes were tracked via Low Back Bournemouth assessment, objective findings and independent clinical examination. RESULTS: Throughout care the patient progressed with non-assisted ambulation, global improvement in balance and movement pattern, decreased Low Back Bournemouth assessment scores from 43% to 23%. DISCUSSION: This therapeutic approach reduced the patient's physical disabilities, enhancing quality of life. CONCLUSION: Chiropractic adjustive care combined with DNS treatment improved functional deficits warranting consideration in subsequent care investigations.

Community-acquired methicillin-resistant Staphylococcus aureus: a potential diagnosis for a 16-year-old athlete with knee pain.

OBJECTIVE: This case report aims to raise awareness in chiropractic physicians of the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in adolescents who participate in sports activities and to alert the chiropractic physician of the necessity to consider potential diagnoses that are not within their typical clinical heuristic. CLINICAL FEATURES: A 16-year-old adolescent girl entered the clinic with a complaint of left knee pain that had an insidious onset during her involvement in sports activities. Later that same day, her knee became enlarged, red, and had pustular formations with a discharge. She was taken to an urgent care facility and subsequently diagnosed with MRSA. Her history included treatment of a left knee musculoskeletal condition 6 weeks prior to which she had responded favorably. INTERVENTIONS AND OUTCOMES: She was treated medically with an aggressive course of antibiotic therapy and excision of the furuncle. The chiropractic physician played a role in patient education and notifying local school authorities of the case. CONCLUSION: Doctors of chiropractic must prepare themselves for the unexpected and remain open to diagnostic possibilities outside of the normal scope of practice. Knee pain or cellulitis of any type may require additional diagnostic and patient care protocols to make the correct diagnosis. With the incidence of community-acquired MRSA increasing at an alarming rate, it is certainly a diagnosis doctors of chiropractic should be aware of when treating patients, especially those involved in sports activities.

Menorrhagia: a synopsis of management focusing on herbal and nutritional supplements, and chiropractic.

INTRODUCTION: To make chiropractors more aware of menorrhagia and how they can serve a role in their patient's care and education since women make up 60% of the population seeking chiropractic care. METHOD: A review of the biomedical literature on menorrhagia was conducted. Items that were retrieved were synthesized and interpreted in order to give the best information to practicing chiropractors. DISCUSSION: Most of the information available relative to menorrhagia is medically oriented. Other treatment options can include: chiropractic, various types of herbs, and nutritional supplements. CONCLUSION: Knowledge of medical treatment, nutritional supplements, along with chiropractic treatment options may be beneficial to doctors in their practice.

Headache caused by an intracranial aneurysm in a 32-year-old woman.

OBJECTIVES: We describe the case of a woman with a headache later found to be a result of an intracranial aneurysm. Through this article, we aim to raise awareness regarding the red flags that should lead doctors of chiropractic to suspect the presence of this condition to facilitate appropriate patient management that increases the likelihood of patients' recovery. CLINICAL PRESENTATION: A 32-year-old woman sought care for a constant headache of 4 days' duration. She described the headache as severe throughout her entire head, centralized at the base of the occiput, and unlike any headache she had experienced. She had concomitant neck pain. Her left eye deviated toward the midline and had excessive tearing 12 hours after the onset of the headache. INTERVENTION AND OUTCOME: No chiropractic adjustment was administered; immediate transfer for emergency treatment was arranged instead. The diagnosis of a bleeding intracranial aneurysm was confirmed by magnetic resonance imaging. The patient was transferred to a local university hospital for surgical intervention. Unfortunately, she died of vasospastic complications. CONCLUSIONS: The red flags to be considered in evaluating patients with such headache as that described for our case patient include a history of hypertension, cigarette smoking, oral contraceptive use, alcohol consumption, pregnancy, and cocaine use. Practitioners need to be aware of the signs and symptoms that indicate whether a headache may be a result of serious problems such as an aneurysm.