Carotidynia presenting with acute ischemic stroke after carotid sinus massage

Hyo Sung Kwak; Gyung Ho Chung; Chan-Hyuk Lee; Seul-Ki Jeong; Han Uk Ryu

doi:10.14253/acn.2017.19.1.46

Journal List > Ann Clin Neurophysiol > v.19(1) > 1099501

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Kwak, Chung, Lee, Jeong, and Ryu: Carotidynia presenting with acute ischemic stroke after carotid sinus massage

Original Article

Ann Clin Neurophysiol 2017;19(1):46-49.

Published online: 5 January 2017

DOI: https://doi.org/10.14253/acn.2017.19.1.46

Carotidynia presenting with acute ischemic stroke after carotid sinus massage

Hyo Sung Kwak¹, Gyung Ho Chung¹, Chan-Hyuk Lee², Seul-Ki Jeong², Han Uk Ryu²

¹Department of Radiology, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea

²Department of Neurology Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea

Correspondence to Han Uk Ryu Department of Neurology and Research Institute of Clinical Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea Tel: +82-63-2501590 Fax: +82-63-2519363 E-mail: iory252@naver.com

Received 9 July 201625 August 2016 Accepted 5 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Carotidynia is characterized by unilateral neck pain around the carotid artery. We describe a 50-year-old woman who presented with transient left-side weakness and right-side neck pain. She frequently massaged the uncomfortable neck area during the symptomatic course of the condition. Magnetic resonance imaging revealed multifocal cerebral infarctions and a carotid intramural thrombus ipsilateral to the carotidynia.Long-term carotidynia might result in the involvement of an intramural thrombus and intimal disruption, and ischemic stroke after carotidynia may be provoked by carotid sinus massage.

Keywords: Carotid artery, Pain, Massage

REFERENCES

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Fig. 1.

A 50-year-old woman with a transient left-side weakness and mild dysarthria. (A) Diffusion-weighted imaging showing multifocal infarctions in the right basal ganglia, frontal cortex, and parietal cortex. (B) Volume-rendering imaging showing a filling defect in the long segment of the CCA and ICA (arrows). (C) Axial source image of time-of-flight carotid MRA showing a massive intraluminal filling defect in the right CCA (arrow). (D) Axial image of nonenhanced T1-weighted carotid MRI showing the intravascular thrombus without an intramural plaque or intimal flap (arrow). (E) Axial image of nonenhanced T2-weighted carotid MRI showing the intravascular thrombus without an intramural plaque or intimal flap (arrow). (F) Contrast-en-hanced MRI of the right CCA showing the circumferential enhancement (arrowheads) with a mural wall thrombus (arrows). (G) Contrast-enhanced MRI of the right ICA showing the intimal disruption (arrow). (H) Contrast-enhanced axial imaging performed 10 days after the initial carotid plaque MRI showing complete resolution of the mural wall thrombus and intimal disruption and a marked decrease in the circumferential carotid wall enhancement. CCA, common carotid artery; ICA, internal carotid artery; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging.

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