“Weak to moderately strong evidence exists to support causation between Cervical Manipulative Therapy (CMT) and Vertebral Arterial Dissection and associated stroke. Ultimately, the acceptable level of risk associated with a therapeutic intervention like CMT must be balanced against evidence of therapeutic efficacy. Further research, employing prospective cohort study designs, is indicated to uncover both the benefits and the harms associated with CMT.” The Neurologist (January 2008) [PDF]