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Stroke as a complication of cervical manipulation and dissection of the vertebral arteries (VAD) is a rare but well recognized problem.
All had elective or nonurgently indicated promotion of labor, digital cervical manipulation, and rapid labor with placental findings of histologically severe intrauterine infection or funisitis, half the time in the absence of classical clinical criteria of chorioamnionitis.
Kawchuk G, Jhangri G, Hurwitz EL, Wynd S, Haldeman S and Hill M (2008): The relation between the spatial distribution of vertebral artery compromise and exposure to cervical manipulation.
Thalamic infarction secondary to cervical manipulation.
Regarding safety of cervical manipulation, which is also a very important issue, a systematic review reported no serious adverse events resulting from the use of cervical manipulation except for minor ones, including transient neurological deficits and an increase in neck pain.