A near-fatal consequence of chiropractor massage: massive stroke from carotid arterial dissection and bilateral vertebral arterial oedema.

Abstract

A 35-year-old Chinese man with no risk factors for stroke presented with a 2-day history of expressive dysphasia and a 1-day history of right-sided weakness. The presentation was preceded by multiple sessions of neck, shoulder girdle and upper back massage for pain relief in the prior 2 weeks. CT of the brain demonstrated an acute left middle cerebral artery infarct and left internal carotid artery dissection. MRI cerebral angiogram confirmed left carotid arterial dissection and intimal oedema of bilateral vertebral arteries. In the absence of other vascular comorbidities and risk factors, massage-induced internal carotid arterial dissection will most likely precipitate the near-fatal cerebrovascular event. The differential diagnosis of stroke in a younger population was consequently reviewed and discussed.

• Authors: Timothy Yap, Li Feng, Dan Xu, Jian Zhang
• Journal: BMJ case reports (BMJ Case Rep) Vol. 14 Issue 8 (Aug 06 2021) ISSN: 1757-790X [Electronic] England
• PMID: 34362754 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Topics

• Adult
• Carotid Artery, Internal, Dissection (diagnostic imaging, etiology)
• Dissection
• Humans
• Male
• Massage
• Stroke (etiology)
• Vertebral Artery Dissection (diagnostic imaging, etiology)