Abnormal behavior in a 2-month-old boy

• Arterial dissection is a potential etiology of stroke that is often overlooked in the pediatric population. • When caring for children with altered mental status, obtaining a thorough history of exposures and alternative therapies, in addition to maintaining a broad differential diagnosis, is paramount. • Although largely based in adult populations, the literature suggests an association with arterial dissection and spine manipulation. However, more work is necessary to understand the utility and safety of chiropractic manipulations in pediatric patients.