![]() We believe that the neck massager destroyed the vascular endothelial cells in this patient, thus forming carotid artery thrombosis and causing an intracranial arterial embolism.Ĭerebral infarction caused by neck massage is often secondary to vascular dissection. After antiplatelet therapy, dynamic reexamination by carotid artery ultrasound showed that the thrombus had significantly reduced and eliminated 21 d after stroke onset. ![]() At the same time, other etiologies, such as cardiogenic, immune, infectious, and hematological diseases, were ruled out. Carotid ultrasound showed symmetrical thrombosis of the bilateral common carotid arteries. The cranial CTA showed that the M3 segment of the upper trunk of the right MCA was occluded. The brain MRI of the patient showed multiple acute infarcts in the right cerebral cortex, similar to arterial embolization. To our knowledge, this report is the first to document a stroke caused by carotid thrombosis due to a neck massager. Her initial National Institutes of Health Stroke Scale (NIHSS) score was 4, the modified Rankin Scale (mRS) score was 4, and her water swallow test grade was 2. The bilateral finger-nose touch, rotation, heel, knee, and tibia tests were stable and accurate, and the closed eyes sign could not be combined. Her left lower limb muscle strength was level 1, left upper limb muscle strength was level 5, right lower and upper limb muscle strength was level 5, and the tendon reflexes of the extremities were normal the muscle tone of the extremities was normal Babinski sign was positive on the left, but negative on the right and bilateral acupuncture sensations and deep sensations were symmetrical. Her cognition seemed normal her speech was a little vague the neck showed soft passivity the Kernig sign was negative the pupils were symmetrical and 3 mm in diameter the light reflex was normal eye movement was normal there was no nystagmus bilateral hearing was symmetrical bilateral nasolabial folds were symmetrical and the tongue could be stuck out on request in the center. The cardiopulmonary examination was normal. The patient’s vital signs were: Body temperature, 37.1 ☌ blood pressure, 122/82 mmHg heart rate, 82 beats per min and respiratory rate, 18 breaths per min. After 1 wk of treatment with aspirin 200 mg and atorvastatin 40 mg, a carotid ultrasound reexamination showed that the thrombosis had significantly reduced. No hypertension, diabetes, heart disease, vasculitis, or thrombophilia was found after admission. Carotid ultrasound showed thrombosis in the bilateral common carotid arteries (approximately 2 cm below the proximal end of the carotid sinus), and contrast-enhanced ultrasound did not suggest enhancement. ![]() ![]() Neck CTA revealed thrombosis of the bilateral common carotid arteries. Computed tomography angiography (CTA) indicated M3 segment embolism of the right middle cerebral artery. Brain magnetic resonance imaging revealed restricted diffusion on diffusion-weighted imaging in the right parietal and temporal lobes. Neurological examination showed left central facial paralysis and left hemiparesis with a National Institutes of Health Stroke Scale score of 12. A 49-year-old woman presented with left limb weakness and dysarthria after a history of neck massage for 1 mo.
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