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Bilateral Carotid and Bilateral Vertebral Artery Dissection Following Facial Massage

Department of Radiology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, laueran{at}ohsu.edu

Walter Zink, MD, PhD

Department of Radiology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York

Robert Zimmerman, MD

Department of Radiology, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York

Howard Riina, MD

Department of Neurological Surgery, Weill Medical College of Cornell University, New York Presbyterian Hospital, New York

Ronald Benitez, MD

Department of Neurological Surgery, Atlantic NeuroSurgical Specialists, Morristown, New Jersey

A 50-year-old woman underwent facial massage. After 13 days, she experienced left retro-orbital pain, ptosis, and miosis. Magnetic resonance imaging (MRI) showed stenotic dissection of bilateral cervical internal carotid and vertebral arteries. The intracranial vasculature was intact. She was treated conservatively with long-term oral anticoagulation and remains asymptomatic 18 months later.

Key Words: stenotic dissection • facial massage • collagen vascular disease • MRI/MRA

This version was published on January 1, 2009

Angiology, Vol. 59, No. 6, 761-764 (2009)
DOI: 10.1177/0003319707309653


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