Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2489
Peer-review started: December 18, 2022
First decision: January 20, 2023
Revised: February 2, 2023
Accepted: March 20, 2023
Article in press: March 20, 2023
Published online: April 16, 2023
There are few reported cases of intracranial large artery embolism due to carotid thrombosis caused by a neck massager. Herein we report such a case.
A 49-year-old woman presented with left limb weakness and dysarthria after a history of neck massage for 1 mo. Neurological examination showed left central facial paralysis and left hemiparesis with a National Institutes of Health Stroke Scale score of 12. Brain magnetic resonance imaging revealed restricted diffusion on diffusion-weighted imaging in the right parietal and temporal lobes. Computed tomography angiography (CTA) indicated M3 segment embolism of the right middle cerebral artery. Neck CTA revealed thrombosis of the bilateral common carotid arteries. 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. No hypertension, diabetes, heart disease, vasculitis, or thrombophilia was found after admission. After 1 wk of treatment with aspirin 200 mg and atorvastatin 40 mg, a carotid ultrasound reexamination showed that the thrombosis had significantly reduced.
Neck massager may cause carotid artery thrombosis.
Core Tip: It has been reported that stroke caused by a neck massager is mainly related to arterial dissection due to the tearing of the inner vessel. Herein we report a rare case of intracranial large artery embolism due to carotid thrombosis caused by a neck massager. Combined with the analysis of the cases indexed in PubMed, only one case of a free thrombus in the carotid artery has been reported, although the etiology is unclear. We found that an intracranial large artery embolism was due to carotid thrombosis caused by a neck massager, which was treated effectively by antiplatelet therapy. In the future, it may be necessary to study further and propose stricter quality management standards for massagers.