Vertebral artery dissection with cerebellar stroke after use of a percussive massage device: illustrative case.

Background: Vertebral artery dissection is a rare condition often due to blunt cerebrovascular injury (BCVI). Electric massage devices have rarely been documented as an etiology of BCVI; however, their use has become widespread. The authors present an illustrative case and literature review of right vertebral artery BCVI and cerebellar infarct following the use of an antique electric massage device.

Observations: A 65-year-old male presented with acute onset vertigo and nausea after using an antique electric massage device on his neck to relieve muscle tension. BCVI in the right vertebral artery was identified via CT angiography (CTA). MRI of the brain confirmed associated cerebellar infarction. Follow-up catheter cerebral angiography confirmed a right V3 segment intraluminal thrombus and V4 segment dissection. After inpatient observation, the patient was discharged on oral anticoagulation. At the 1-month follow-up, he reported no new symptoms, and CTA revealed resolution of the V3 thrombus and healing V4 dissection.

Lessons: The authors report the first case of MRI-proven stroke in association with vertebral artery BCVI after the use of an antique electric massage device. This case highlights the need for kinetic studies to assess the force distribution of percussive instruments in an effort to prevent injuries. https://thejns.org/doi/10.3171/CASE24812.