Article Text

Download PDFPDF
A near-fatal consequence of chiropractor massage: massive stroke from carotid arterial dissection and bilateral vertebral arterial oedema
  1. Timothy Yap1,
  2. Li Feng2,
  3. Dan Xu1,3,4 and
  4. Jian Zhang2
  1. 1Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  2. 2Deaprtment of Neurology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  3. 3Curtin School of Population Health, Faculty of Health Sciences, Curtin University Bentley Campus, Perth, Western Australia, Australia
  4. 4Medical Education & General Practice, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
  1. Correspondence to Professor Dan Xu; daniel.xu{at}


A 35-year-old Chinese man with no risk factors for stroke presented with a 2-day history of expressive dysphasia and a 1-day history of right-sided weakness. The presentation was preceded by multiple sessions of neck, shoulder girdle and upper back massage for pain relief in the prior 2 weeks. CT of the brain demonstrated an acute left middle cerebral artery infarct and left internal carotid artery dissection. MRI cerebral angiogram confirmed left carotid arterial dissection and intimal oedema of bilateral vertebral arteries. In the absence of other vascular comorbidities and risk factors, massage-induced internal carotid arterial dissection will most likely precipitate the near-fatal cerebrovascular event. The differential diagnosis of stroke in a younger population was consequently reviewed and discussed.

  • stroke
  • neurological injury

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors TY drafted the initial manuscript, and reviewed the final manuscript and figures. LF, DX and JZ designed and reviewed the manuscript and figures.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.