Eyes are open. Use the first two fingers and contact the transverse process of the atlas medial to the longissimus capitis. Move the splenius and semispinalis capitis medially while penetrating just past the lateral mass of the atlas inferior to the superior oblique. Without sliding, hold tension medially and superiorly just inferior to the superior oblique and superior to the atlas while slowly rotating the patient s head ipsilaterally. Hold the rotated position for 10 seconds or until symptoms develop.
Vestibular vertigo is more pronounced with head movements in more than one plane.
All treatment protocols are specifically modified for this lesion. Given the possibility of false negative results with current screening procedures for vertebral-basilar insufficiency, it is prudent to incorporate the VATT prior to cervical manipulation procedures. It is also this author s opinion that rotary upper cervical manipulation should be avoided until the positive VATT is resolved and that such manipulation then be added in cases of clinical necessity. He received his B.S. Engineering degree from the USAF Academy in 1971 and graduated Summa Cum Laude from Los Angeles College of Chiropractic in 1984. He teaches ART with University of California San Diego School of Medicine.