Restoration of Normal CerebroSpinal
Fluid Flow in 2 Cases of Confirmed
Cerebelar Tonsilar Ectopia with
Long-Term Headaches, Following Use
of The Atlas Orthogonal Instrumented
Manipulation Technique


Scott Rosa1; Michael Freeman2; David Harshfield3
1Sweat Foundation, Rock Hill, 2Oregon Health and Science
University School of Medicine, Department of Public Health
and Preventive Medicine, Portland, and 3Private Practice,
Little Rock, USA


Introduction: We report on two patients who presented with
severe, long-standing headaches and other complications
following whiplash trauma secondary to a motor vehicle
crash (MVC). Materials and Methods: Both patients were
examined in an upright MRI utilizing cerebral spinal fluid
(CSF) flow cine software, which allowed for evaluation of
CSF flow. It was noted that in each patient there was a static
misalignment of the 1st cervical vertebra (Atlas), as well
as substantially reduced CSF flow at the cranio-cervical
junction associated with cerebellar tonsillar ectopia. Both
patients received a manipulation directed at the C1 misalignment
utilizing the atlas orthogonal procedure (instrumented
manipulation). Results: Within an hour of the atlas
orthogonal correction both patients were rescanned for CSF
flow. In both cases restoration of normal flow was observed.

Additionally, the headache pain level was nearly eliminated
immediately post treatment in both patients. Subsequent
follow-up has demonstrated persisting improvement in
headache severity, with similar nearly instantaneous results
with the same procedure of instrumented manipulation when
the headaches symptoms have returned. Conclusions: Prior
research has demonstrated a correlation between CSF flow
obstruction and intracranial pressure headaches. This is a
potentially significant clinical finding (CSF obstruction) that
can lead to long-term and often unexplained complaints of
unresolved headaches, neck pain, paresthesias, numbness,
and a variety of other symptoms that are often associated
with cerebellar tonsillar ectopia. A larger study with a control
group is currently underway to evaluate the reproducibility
of these findings
.