"The risks of neck manipulation are not trivial. The primary risk is that aggressive neck manipulation may cause a tear (called a dissection) in one of the four arteries that feed the brain — two carotids to the front of the brain and two vertebrals to the back. If a tear forms in one of these arteries then a clot (called a thrombus) can form around that tear, blocking off flow through the artery and causing a stroke. It is also possible that the thrombus may break lose and flow downstream and then lodge in and completely block off an artery — when a clot moves it is called an embolus. This is apparently what happened to Sandra Nette…this case should be a wake up call. The government cannot continue to license nonsense and call it medicine. The public deserves better. I also think that public awareness about the risks of neck manipulation needs to be raised, and more importantly this practice needs to simply stop. Watch how the government and chiropractors respond to this law suit. It will be very telling." Steven Novella, MD, NeuroLogica Blog (17th June 2008)