Cervical Artery Dissection and Cerebral Infarction Following Cervical Massage

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Cervical massage poses a risk for craniocervical arterial dissection, a precursor to ischemic stroke.
• Vascular dissection increases thrombosis, cerebral ischemia, paralysis, and mortality risks, particularly with carotid calcification and elongated styloid processes.
• Adverse events from cervical massage in older adults with predisposing factors are rarely reported.

Purpose of the Study:

• To report a rare case of ischemic stroke following cervical massage in an older adult.
• To highlight the association between cervical massage, arterial dissection, and stroke.
• To emphasize the importance of recognizing risk factors and prompt management.

Main Methods:

• A case study of an older adult experiencing aphasia and right-sided weakness post-cervical massage.
• Diagnostic imaging using computed tomography angiography (CTA) to identify carotid artery dissection, calcification, and styloid process elongation.
• Treatment involved intravenous thrombolysis followed by 3 months of dual antiplatelet therapy.

Main Results:

• CTA confirmed carotid artery dissection, significant arterial calcification, and an elongated styloid process.
• The ischemic stroke was attributed to thromboembolism secondary to carotid intimal injury and plaque rupture.
• The patient showed no recurrent ischemic events during follow-up after treatment.

Conclusions:

• Cervical massage carries potential cerebrovascular risks, necessitating increased awareness, especially in patients with vascular abnormalities.
• Clinical vigilance is essential for preventing severe cerebrovascular complications.
• Early recognition and appropriate management of dissection following massage can prevent further ischemic events.