Extracranial vertebral artery rupture likely secondary to “cupping therapy” superimposed on spontaneous dissection

Abstract

<jats:p> The extracranial vertebral artery (VA) is vulnerable to dissection and the V3 segment is the most common location for dissection. Dissection accounts for about 2% of all ischemic strokes and can occur after trauma or chiropractic neck maneuvers. We report an extremely rare case of spontaneous extracranial VA dissection presenting with posterior neck hematoma aggravated after cupping therapy, a treatment in traditional Oriental medicine. We treated the patient successfully by endovascular treatment without any complication. </jats:p>

Extracranial vertebral artery rupture likely secondary to “cupping therapy” superimposed on spontaneous dissection

“…We reported an extremely rare case of spontaneous extracranial vertebral artery dissection (VAD) presenting with posterior neck hematoma, which had been aggravated after a cupping therapy. 1 In our paper, we did not argue that spinal manipulative therapy, such as chiropractic treatment, directly causes VAD. We accepted that with undiagnosed VAD, traditional Oriental remedies-like the cupping treatment-may reduce pain and reduce aggravation of symptoms.…”

“…Extracranial vertebral artery rupture likely secondary to ''cupping therapy'' superimposed on spontaneous dissection Jae Young Choi 1…”

Intracranial mycotic aneurysm rupture following cupping therapy

“…Cupping therapy has been reported to cause cerebrovascular diseases, including intracerebral hemorrhage, extracranial vertebral artery dissection, and cervical artery dissection. [ 6 , 3 , 13 ] These outcomes have been linked to the discomfort caused by the procedure and sudden changes in blood pressure due to stimulation of the carotid sinus baroreceptors. However, in this case, no abnormal findings were observed in the cervical vessels, including the vertebral artery.…”

“…Meanwhile, wet cupping therapy has been linked to serious infectious complications, including the development of necrotizing fasciitis. [ 1 ] Although few reports exist on stroke onset following cupping therapy,[ 6 , 3 , 13 ] none have documented cases of ruptured intracranial mycotic aneurysms (ICMAs). Herein, we report a case of infective endocarditis (IE) and ICMA rupture after wet cupping therapy.…”