Pan J, Wang JW, Cai XF, Lu KF, Wang ZZ, Guo SY. Intracranial large artery embolism due to carotid thrombosis caused by a neck massager: A case report. World J Clin Cases 2023; 11(11): 2489-2495 [PMID: 37123320 DOI: 10.12998/wjcc.v11.i11.2489]
Corresponding Author of This Article
Shun-Yuan Guo, MM, Chief Physician, Doctor, Teacher, Department of Neurology, Zhejiang Provincial People's Hospital, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. gsy9316@126.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jie Pan, Xiao-Feng Cai, Shun-Yuan Guo, Department of Neurology, Zhejiang Provincial People's Hospital, Hangzhou 310014, Zhejiang Province, China
Jing-Wen Wang, Department of Neurology, Tiantai People's Hospital of Zhejiang Province, Taizhou 317200, Zhejiang Province, China
Ke-Feng Lu, Zhen-Zhen Wang, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Pan J and Wang JW contributed equally to this work; Pan J, Wang JW, Guo SY, and Cai XF discovered the case; Lu KF and Wang ZZ verified it through B-scan; Pan J and Wang JW analyzed the reason and wrote the manuscript; All authors have read and approved the final manuscript.
Supported byZhejiang Traditional Chinese Medicine Science and Technology Program, No. 2023ZL259.
Informed consent statement: Informed written consent was obtained from the patient to publish this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shun-Yuan Guo, MM, Chief Physician, Doctor, Teacher, Department of Neurology, Zhejiang Provincial People's Hospital, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. gsy9316@126.com
Received: December 18, 2022 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 Processing time: 108 Days and 19.5 Hours
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
