Strokes and Chiropractic Care

1. Stroke
worldwide prevalence of stroke:
•33 million
•16.9 million first stroke
•second-leading global cause of death
•11.13% of total deaths worldwide
•No. 4 cause of death in the United States
•killing 129,000 people a year
• 795,000 people have a stroke every year in USA
•U.S. has a stroke about once every 40 seconds
•1 of every 20 deaths in the U.S.
•Stroke is a leading cause of disability.

2. Causes of Stroke
Hemorrhagic weak Blood Vessels
Thrombotic (Blood Clots) Toxic Blood

3. On August 7, 2014, the American Heart Association/American
Stroke Association
“Neck Manipulation May Be Associated With Stroke,” by José
Biller, MD, lead author and professor and chair of neurology at the
Loyola University Chicago Stritch School of Medicine.
“Treatments involving neck manipulation may be associated with
stroke, though it cannot be said with certainty that neck
manipulation causes strokes, according to a new scientific
statement published in the American Heart Association’s journal
Stroke.”
Criminally Misleading !!

4. Dick 69yo
•High Blood Pressure 10yr
•High Cholesterol 10 yr
“I’m Not going
to let you touch
me until I talk to
my Cardiologist”

5. •SMT = 1 in 5.85 million cases
•one occurrence in 48 chiropractic careers.
•death resulting from NSAID use is 1,500 times greater than
the risk of injury from cervical SMT.
• hit by lightning 1 in in 600,000
“We didn’t see any increased association between
chiropractic care and usual family physician care,
and stroke,”
said Frank Silver, researcher, a professor of medicine at the
University of Toronto and director of the University Health
Network stroke program

6. •annual incidence is about 3.3 per 100,000
•slightly higher incidence in men (56% versus 44%)
•Men are on average 37–44 years old at diagnosis, and women
34–44
•dissection of the carotid and vertebral arteries accounts for only
2% of strokes
•cause 10–25% of strokes in young and middle-aged people
•about 2.5% in older patients.
•increased in patients with fibromuscular dysplasia
•Migraine
•Hypertension
•Smokers
•oral contraceptives
•Trauma
•NSAID’s
Vertebral Artery Dissections

7. Put the Risk into Perspective
The risk for strokes associated with vertebral artery
dissection
•general population without manipulation is 2 in 100,000
per year
•With manipulation is 1 in 5.8 million treatment sessions
•Stroke Risk With Chiropractic care 0.00000017
•Stroke Risk Without Chiropractic care 0.00002
•lumbar spine surgery, the death rate is 7 in 10,000
•two-month course of NSAIDs, risk of death: one in
1,200
•death rate for acetaminophen is 1 in 2 million tablets
sold

8. A study by Anthony Rosner, PhD,
comparing medical procedures to chiropractic care
Using the estimate of 1 per 1 million as an estimate of
stroke incidence attributed to cervical manipulations:
•two times greater risk of dying from transfusing one unit of
blood
•100 times greater risk of dying from general anesthesia
•160-400 times greater risk of dying from use of NSAIDs
•700 times greater risk of dying from lumbar spinal surgery
•1000-10,000 times greater risk of dying from traditional gall
bladder surgery
•10,000 times greater risk of serious harm from medical
mistakes in hospitals
How many patients were able to avoid death and
injury by avoiding medical and surgical
interventions by getting appropriate Chiropractic
Care?”

9. Objective.
•In older adults with a neuromusculoskeletal complaint
•to evaluate risk of injury to the head, neck or trunk following an office visit
for chiropractic spinal manipulation
•as compared to office visit for evaluation by primary care physician
•we evaluated for adjusted risk of injury within 7 days
•those treated by chiropractic spinal manipulation vs. those evaluated by
a primary care physician
Risk of Traumatic Injury Associated with
Chiropractic Spinal Manipulation in Medicare Part
B Beneficiaries Aged 66-99.
Spine: December 9, 2014
Summary of Background Data. The risk of physical injury due
to spinal manipulation has not been rigorously evaluated for
older adults, a population particularly vulnerable to traumatic
injury in general.
Risk of Traumatic Injury Associated with Medical
Evaluations in Medicare Part B Beneficiaries Aged
66-99.
How many patients were able to avoid death and
injury by avoiding medical and surgical
interventions by getting appropriate Chiropractic
Care?”

10. probability of injury:
• Chiropractic 40 injury incidents per 100,000
•primary care 153 incidents per 100,000
Risk of Traumatic Injury Associated with
Chiropractic Spinal Manipulation in Medicare Part
B Beneficiaries Aged 66-99.
risk of injury to the head, neck or trunk within 7 days was
76% lower among subjects with a chiropractic office visit
as compared to those who saw a primary care physician.
The study did not take into account the increased risk
for any form of medical treatment or drugs as the
medical comparison was only done on "...those
evaluated by a primary care physician."
Warning Medical evaluations 382%
Greater Risk of injury to Seniors
vs Chiropractic Care

11. Review: could Enbrel cause Artery dissection?
3 people for 174,963
•Summary: Artery dissection is reported only by a few people who take Enbrel.
•174,963 people who have side effects while taking Enbrel
• 3 have Artery dissection
•used in rheumatoid arthritis.
Artery dissection
Artery dissection has been reported by people with birth control, headache, migraine,
dizziness, pain
< 1
month
1 - 6
months
6 - 12
months
1 - 2
years
2 - 5
years
5 - 10
years
10+
years
Artery
dissection
0.00% 100.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Top conditions involved for these people
1.Rheumatoid arthritis (3 people, 100.00%)
2.Diabetes mellitus (2 people, 66.67%)
3.Hypertension (2 people, 66.67%)
4.Constipation (2 people, 66.67%)
5.Insomnia (2 people, 66.67%)
Top co-used drugs for these
people * :
1.Diovan (3 people, 100.00%)
2.Amaryl (3 people, 100.00%)
3.Prednisolone (3 people, 100.00%)
4.Depas (3 people, 100.00%)
5.Selbex (3 people, 100.00%)

12. Review: could Humira cause Carotid artery dissection?
•Out of 135,988 people who have side effects while taking Humira
•4 have Carotid artery dissection
•often used in rheumatoid arthritis
Carotid artery dissection
•birth control
•high blood pressure
•multiple sclerosis
•Migraine
•Stress
•Anxiety.
< 1
month
1 - 6
months
6 - 12
months
1 - 2
years
2 - 5
years
5 - 10
years
10+
years
Carotid
artery
dissection
0.00% 100.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Top co-used drugs for these
people:
Lisinopril (1 people, 25.00%)
Omeprazole (1 people, 25.00%)
Boniva (1 people, 25.00%)
Prednisolone (1 people, 25.00%)
Sulfasalazine (1 people, 25.00%)
Top conditions involved for these people:
Rheumatoid arthritis (4 people, 100.00%)
Hypertension (1 people, 25.00%)
Gastrooesophageal reflux disease (1 people,
25.00%)
Osteoporosis (1 people, 25.00%)

13. Risk
Frequency
(per Million)
Neurological Complications From Cervical
Manipulations
0.0000001
Canoeing 3
Soccer or Football 39
Venipuncture 40
Drinking: 1 Bottle of Wine per Day 75
Automobile Driving (United Kingdom) 169
Nuclear Bone Scan 333
GI Bleeding Due to NSAID Use 400
Spinal Surgery 700
Smoking: 20 Cigarettes per Day 5000
Appendectomies 13,500
Total Hip Replacement 4900-15,300
Motorcycling 20,000
Risk in
Perspective:
Comparison of
Death Rates
Attributed to
Various Causes

14. Angiography
Bleeding nose
Axial traction
Calisthenics
Cervical extension for xrays or CTS
Cervical rotation while backing up a car
Coughing
Dental procedure
Football
Gymnastics
Hanging out washing
Overhead work
Roller coaster
Telephone call
Traction and short wave diathermy
Trampoline
Watching aircraft
Yawning
Activities Suspected of Disrupting
Cerebral Circulation

15. Activities Associated With CVAs
Cerebral Vascular Accidents
Archery
Beauty parlor stroke
By surgeon or anethetist during surgery
Calisthenics
Childbirth
Emergency resuscitation
Fitness exercise
Neck extension during radiography
Neck extension for a bleeding nose
Overhead work
Rap dancing
Sleeping position
Star gazing
Swimming
Tai Chi
Turning the head while driving a vehicle
Wrestling
Yoga

16. Probability of Stroke or Serious Adverse Events Following Cervical
Manipulation
Methods Risk
Clinical files of National College 0 complication/
5,000,000 in 15 year period
Canadian Memorial Chiropractic College Clinic 0 complication/
5,000,000 in 9 year period
RAND Cervical Study Literature Review 0.64 Serious Complications /
1,000,000
0.27 Deaths/ 1,000,000
Claim Review: Canada's Largest Malpractice
Insurance Company
1 CVA/ 3,000,000
0 Deaths in 5 Year Period
Claim Review: Principal Chiropractic Malpractice
Insurance Company Within the U.S.
1 CVA/ 2,000,000
in a 3 Year Period
Claim Review: Canada's Largest Malpractice
Insurance Company
0.17 CVA/ 1,000,000
in a 10 Year Period

17. 2000-2010 Task Force on Neck Pain and Its
Associated Disorders
A Canadian study
indicated there was no increased risk related to
chiropractic treatment in the debate about whether
neck adjustments can trigger a rare type of stroke.
Researchers found patients are no more likely to
suffer a stroke following a visit to a chiropractor
than they would after stepping into their family
doctor's office.

18. The American Medical System
Is The Leading Cause Of Death And
Injury In The United States
By Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD,
Debora Rasio MD, Dorothy Smith PhD
•In-hospital adverse drug reactions (ADR) to prescribed med’s
2.2 million.
•The number of unnecessary medical and surgical procedures
performed annually is 7.5 million
•Unnecessary hospitalization annually is 8.9 million
•Iatrogenic deaths is 783,936
•2001 heart disease annual death rate is 699,697
•The annual cancer death rate is 553,251.

19. 61 yo male Robert
Stroke 3 years before Chiropractic care
High BP Meds 15 years
Cholesterol Meds 10 Years

20. "Our analysis indicates that in settings of high recurrent
intracerebral hemorrhage risk, avoiding statin therapy may
be preferred,“
Dr. Brandon Westover of Massachusetts General Hospital and Harvard
Medical School and colleagues wrote in the Archives of Neurology.
“The researchers said it is not clear how statins increase the
bleeding risk ….. “
Pfizer's Lipitor or atorvastatin has global sales of $11 billion a
year while
AstraZeneca's Crestor has global sales of more than $5 billion.
“statins are commonly used to prevent heart attacks and strokes,
(Statins) could increase the risks of a second stroke in these
patients, outweighing any other heart benefits from the drugs.”
Cholesterol Lowering Medication Increase
Stroke Risk

21. “Despite the greater improvements in lipids, there was no
differences in calcified plaque progression. The
conclusion: with respect to LDL cholesterol lowering,
“lower is better” is NOT supported by changes in calcified
plaque progression.”
This means yourarteries have no less plaque than
before treatment!
American Journal of Cardiology 2003, August 1; 92(3): 334-6
What Are Your
Cholesterol
Drugs Doing For
You?

22.  13 studies were included. Of 34533 patients, 18315 received intensive glucose
lowering treatment and 16218 standard treatment.
 a more than twofold increase in the risk of severe hypoglycaemia.
 Over a treatment period of five years, 150 patients would need to be treated to
avoid one myocardial infarction
 142 patients to avoid one episode of microalbuminuria
 47% increase in risk of congestive heart failure
 9% reduction of glucose = 19% increase in all cause mortality
 14% reduction of glucose = 43% increase in cardiovascular death.
 BMJ 2011; 343 doi: 10.1136/bmj.d4169 (Published 26 July 2011) Cite this as: BMJ
2011;343:d4169
9% reduction of glucose = 19% increase in all cause mortality
14% reduction of glucose = 43% increase in cardiovascular death.

24.  The Angiogram has become the gold standard
for testing heart patients.
 It is done more than a million times/year
 Cost: More Than $1 000 000 000.00 per year
 Accurate: ONLY 22% OF THE TIME
 Source: National Heart Lung, Blood Institute/ “Interobserver Variability in
Coronary Angiography,” Circulation 53 No. 4 (Apr 76: 627-632)

25.  Inter-observer Variability: 33%
 Same test read by the same
person: Diagnosis was the
same only 1/3 of the time.
 Source: National Heart Lung, Blood Institute/ “Inter-observer
Variability in Coronary Angiography,” Circulation 53 No. 4 (Apr 76:
627-632)

26. The average death rate for
bypass surgery is greater than
the average death rate of heart
patients treated without
surgery.
Heart disease progresses faster
in those who have had
invasive surgery than in those
treated non-surgically.
Heart Surgery kills thousands
of patients per year and
debilitates thousands more.

27.  Nearly Half …..46%
 How Many is Operations is that?
 In 1987…..110 000 operations
 In 1990…..180 000 operations
 Despite the preponderance of scientific evidence, they,
bypass and other invasive heart surgeries are still being
performed at an alarming rate, with increases every
year.
 Source: The Appropriateness of Performing Coronary Artery Bypass
Surgery: JAMA 260, no.4 (July22/29. 1988)

29. Normal Bipolar Disorder
Depression
The Curve in the Neck is the Arch of Life

30. 1. Stop viruses adhering to cell
walls
(Cranberry bladder infect)
2. Antioxidant
3. Antibacterial
4. Stimulate or suppress enzymes
5. Stop Abnormal DNA replication
(Cancer)

31. Juicing helps you absorb all the nutrients
from the vegetables. Juicing will help to "pre-
digest" them for you, so you will receive most
of the nutrition, rather than having it go down
the toilet.
Juicing allows you to consume an optimal
amount of vegetables in an efficient
manner. You should eat one pound of raw
vegetables per 50 pounds of body weight per
day.
You can add a wider variety of vegetables
in your diet.

32.  A study of more than 125,000 healthcare workers found that just one
additional daily serving of fruit or vegetables lowered the risk of heart
disease.
 Vegetables such as spinach , kale , broccoli and fruits such as
oranges , grapefruits Fiber , potassium , folate , antioxidants
 Annals of Internal Medicine June 19, 2001;134:1106-1114
Just One Extra Serving of Vegetables
 Flavonoids are found in numerous fruits and vegetables, as well as in
certain types of tea. Flavonoids appear to reduce oxidation of LDL
cholesterol in the bloodstream, preventing cholesterol from sticking
to artery walls, which can lead to clogged arteries and boost heart attack
risk.
 American Journal of Epidemiology May 15, 1999;149:943-949

33. Calvin 60 yo Before:
•High BP Meds
•High Cholesterol Meds
•NSAID’s Calvin 60 yo 90 days after:

34. Proper nerve supply –
FREE of subluxation
Regular Exercise
Proper Nutrition
Sufficient Rest
Prayer and Meditation
Keep Informed, Stay Healthy:

35. www.owners-guide.com
Free 7 day Trial
Free access if You Are a
Bergman Family Chiropractic Patient
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36. Take Action Today
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37. www.youtube.com
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38. TheThe
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