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Carotid dissection associated with a handheld electric massager
1Department of Neurology, University of California Irvine, Irvine, CA, USA. grantac@uci.edu
Southern Medical Journal
|January 14, 2005
Summary
Neck massage with a handheld electric massager may lead to internal carotid artery (ICA) dissection and stroke. This case highlights the risk of even low-amplitude, high-frequency forces causing serious vascular injury.
Area of Science:
- Neurology
- Vascular Surgery
- Biomedical Engineering
Background:
- The extracranial internal carotid artery (ICA) is vulnerable to dissection from neck trauma.
- Repetitive, lower-amplitude forces over time can also pose a risk for ICA dissection.
- Understanding mechanisms of non-traumatic vascular injury is crucial for prevention.
Observation:
- A 38-year-old woman experienced sudden dysarthria and left hemiparesis.
- Symptoms appeared days after a 20-minute neck massage using a handheld electric massager.
- The massager utilized two 2-cm spheres with low-amplitude, high-frequency percussion.
Findings:
- Magnetic resonance imaging and angiography revealed acute right middle cerebral artery territory infarction.
- Dissection of the extracranial right internal carotid artery (ICA) was confirmed.
- The patient had no prior significant stroke risk factors.
Implications:
- Handheld electric massagers can potentially cause internal carotid artery (ICA) dissection.
- This mechanism may lead to disabling ischemic stroke.
- Clinicians should consider iatrogenic vascular injury from such devices in differential diagnoses.