Intensive Knee Chest Upper Cervical Chiropractic Care in a Traveling Patient With Migraine: A Case Report

Migraine and cluster headache are disabling primary headache disorders that may respond to upper cervical intervention via shared trigeminocervical mechanisms, though clinical evidence for this approach in migraine specifically remains limited and mixed.We report a 46-year-old female program coordinator, resident in Sri Lanka, with a 10-year history of migraine who developed a new, daily headache pattern that she described as "cluster headache", a label of uncertain clinical provenance reported here as an unconfirmed differential.She was also hospitalized for two nights with a two-week headache exacerbation, vomiting, and blurred vision, discharged with a diagnosis of status migrainosus after morphine and an occipital nerve block.About one week after discharge, she developed transient neurological symptoms, including confusion and memory difficulty, without contemporaneous imaging workup.Examination and imaging identified postural asymmetry and a C1 subluxation complex.Because knee chest upper cervical (KCUC) chiropractic is unavailable in her home country, she traveled to Singapore for an intensive, twicedaily care model over six days and then three visits at the four-month follow-up.Baseline Bournemouth Questionnaire score was 37/70.By the end of the intensive week, examination findings had normalized, with resolution of photophobia and phonophobia and regained occipital sensation.At the four-month follow-up, she reported approximately 95% headache improvement and resolution of cognitive and visual symptoms, with no adverse events.This case illustrates a temporal association between intensive KCUC care and improvement in a patient with migraine, status migrainosus, and a self-described cluster headache-like pattern and highlights considerations for chiropractic care delivered to patients traveling internationally for care unavailable at home.