Eight months ago, i asked the question: did chiropractic manipulation of she neck cause Katie May’s stroke? Now, it appears, I understand the answer, and the answer is yes:

Katie May, a design who posed because that Playboy and also gained a massive following ~ above Snapchat, endured a “catastrophic” punch in early on February and also later died after gift taken off life-support. Now, TMZ reports reports that a visit come the chiropractor left her with an injury that precipitated the stroke.

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TMZ acquired May’s fatality certificate, which says that she suffered a blunt force injury during a “neck manipulation by chiropractor.” that injury tore one artery in she neck and cut turn off blood flow to she brain, which led to the hit that eliminated her.

Several of you e-mailed me news reports of the coroner’s finding (as fine as other stories to express the TMZ story). To it is in honest, I had forgotten around this story, not having heard anything around it since I blogged around it in February, and I to be surprised at exactly how this update came seemingly the end of the blue. Ns would have loved to check out the really autopsy report, fairly than a snippet of that quoted by TMZ and also other magazines, however I take what I deserve to get.

Before this story, I need to admit that i didn’t know who Katie may was, however I did find out that she was well-known as the “Queen the Snapchat,” for she posting of picture of it s her in i m sorry she was scantily clad. Indeed, between Instagram and also Snapchat, she had actually quite the society media empire going. At the time of she death, she was just 34 years old and also left behind a seven year old daughter. It was a horrible, catastrophic tale. May was young and also building a business, and also her death was totally unnecessary, making it even more depressing to contemplate.

Here’s what happened. So late last January, might was act a photograph shoot. The unclear exactly how it happened, however somehow it did happen. Might fell—hard—and hit she neck or head top top something. Afterward, she complained of neck pain the was intense sufficient that she apparently went come the emergency room to be confirm out. Actually, stories differ here, with what her family members said, namely the she never ever sought clinical care. Be that as it may, we do know that might went come a chiropractor because that a neck adjustment, together she Tweeted soon afterward:

Pinched a nerve in mine neck on a Photoshoot and got adjusted this morning. It really hurts! any home remedy suggestions loves? XOXO

— Katie might (
Ms_katiemay) January 29, 2016

Two job later, might responded to a fan that asked just how her neck was feeling:

Thanks love! the still hurts, going back to chiropractor morning xoxoxo https://t.co/xTw080sjrK

— Katie may (
Ms_katiemay) February 1, 2016

So might went to her chiropractor top top February 1. That evening, she collapsed and also was rushed come the hospital. It to be a Monday. By Thursday evening, she was gotten rid of from life support, and also died a few hours later.

If you read my previous article on the Katie May, you could remember that I spent a lot of verbiage in my very own inimitable fashion going end a couple of questions. First, was it a stroke native chiropractic manipulation that killed Katie May? Second, what is the evidence base covering chiropractic manipulation and stroke? As component of the 2nd discussion, I discussed that, while the proof base supporting chiropractic manipulation as a reason of strokes due to occlusion the the vertebral or basilar arteries is nice convincing, the evidence that chiropractic manipulation can cause carotid artery injury is much less convincing.

It’s also less plausible, too, provided that there is a clean physical system for injury come the vertebral arteries. To aid you see why, I believed it would certainly be worthwhile to post this picture again, laying the end the anatomy the the vertebrobasilar system. Basically, two really important arteries that supply blood to the brain pass through the two greatest vertebrae, the atlas (C1, therefore named since it was believed to assistance the head the way the mythical Atlas held up the earth) and the axis (C2). Importantly for understanding just how chiropractic could cause vertebrobasilar strokes, the vertebral arteries are tethered come the spine and also make a huge loop about the atlas prior to entering the skull and merging to kind the basilar artery (click come embiggen):


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Vertebral artery anatomy. The arrows suggest to the vertebral artery. Note how it bends about bony protrusions.

It’s not challenging to see exactly how a fast rotation that the head might potentially stretch the basilar arteries. Generally, chiropractors describe this together “high velocity, low amplitude” (HVLA), which it is, but, offered the border of vertebral artery anatomy, high amplitude is not compelled to cause injury. With HVLA, it is quite feasible to tear the intima (the lining the the artery consists of vascular endothelial cells). Intimal tears become “sticky” for platelets, leading them come lodge there and start to form a clot. This is the same reason atherosclerotic plaques deserve to lead to strokes once they are in the carotid artery and can cause myocardial infarctions (death of love muscle; a.k.a., a love attack) once in the coronary arteries. The “rough” area that the plaque is thrombogenic; i.e., has actually a tendency to entice platelets and also cause clots. As soon as a clot creates in such an injured area that intima, nevertheless of where the artery is, one of three things deserve to happen. It deserve to resolve completely, i beg your pardon is what generally happens; it can resolve yet leave a small segment the the artery as it resolves; or it have the right to break off and also flow further downstream, there to lodge where the artery narrows and block blood flow. Once that happens in the brain, it’s referred to as a stroke.

Now, take a look at chiropractic neck manipulation:

And here’s another example:

And quiet more:

You acquire the idea. If you cringe when you hear the pop during the violent twist provided to the neck, you’re not alone. So execute I. The is the “high velocity, short amplitude” (HVLA) twisted that deserve to injure the intima that the artery, setup up the condition for a stroke. What surprises me is that the risk isn’t much greater than what studies show. The human body is an ext resilient 보다 one would imagine, and, missing pre-existing atherosclerotic disease, the risk remains low. On the other hand, offered that there is no benefit from HVLA chiropractic neck manipulation, the risk-benefit proportion is basically infinity, because the potential benefit is zero. Also, the risk could be small, but, as Katie might shows us, the the results of the risk have the right to be catastrophic.

Another aspect I questioned was whether Katie May’s stroke can have been due to the trauma she suffered at her picture shoot a job or two prior to her an initial chiropractic manipulation. Currently that us know, assuming that TMZ is accurately relaying the results of the coroner’s report, that May had actually a tear in her left vertebral artery, the almost particular that the chiropractor accidentally eliminated her with neck manipulation. The is what the coroner concluded, that this injury to she vertebral artery arisen during chiropractic neck manipulation.

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In the end, over there is no longer any reasonable doubt. Katie May’s fatality was unnecessary and also due to she subjecting it s her to the quackery that is chiropractic.