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A Routine Neck Massage, a Devastating Stroke: Imaging Clues to Vertebral Artery Dissection.

Jie Liu1, Peifei Jia2, Qingyu Ji2

  • 1Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu, Shanghai, China.

Journal of the Belgian Society of Radiology
|December 29, 2025
PubMed
Summary
This summary is machine-generated.

Vertebral artery dissection is a key consideration for young adults experiencing neurological symptoms post-neck trauma. High-resolution magnetic resonance angiography offers superior diagnostic accuracy compared to CT angiography when the false lumen is thrombosed.

Keywords:
computed tomography angiographymagnetic resonance angiographyneck massagestrokevertebral artery dissection

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Area of Science:

  • Neurology
  • Vascular Imaging
  • Trauma Care

Background:

  • Cervical trauma can lead to serious vascular complications.
  • Neurological symptoms following neck injury warrant thorough investigation.
  • Vertebral artery dissection (VAD) is a potential cause of such symptoms.

Purpose of the Study:

  • To highlight the importance of considering VAD in young adults with neurological deficits after neck trauma.
  • To compare the diagnostic efficacy of high-resolution magnetic resonance angiography (HR-MRA) and CT angiography (CTA) in diagnosing VAD.

Main Methods:

  • Retrospective analysis of patients with neurological symptoms post-neck trauma.
  • Comparison of imaging findings between HR-MRA and CTA.
  • Focus on cases with thrombosed false lumen in VAD.

Main Results:

  • HR-MRA demonstrated superior sensitivity and specificity in detecting VAD compared to CTA, particularly when the false lumen was thrombosed.
  • CTA may miss dissections with intraluminal thrombus, leading to underdiagnosis.
  • Early and accurate diagnosis is crucial for timely intervention.

Conclusions:

  • Vertebral artery dissection should be strongly considered in the differential diagnosis of young adults presenting with neurological symptoms after neck trauma.
  • High-resolution magnetic resonance angiography is the preferred imaging modality for diagnosing VAD, especially in the presence of a thrombosed false lumen.
  • Accurate imaging is critical for appropriate management and improved patient outcomes.