Left Internal Carotid Artery Dissection Secondary to Minor Trauma: A Case Report Involving "Headbanging" in a Heavy Metal Band.
- 1Neurology and Neurosurgery Department NeuroDOC Curitiba Brazil.
- 2Neurology and Neurosurgery Department Hospital Santa Cruz Curitiba Paraná Brazil.
Abstract
Introduction
Internal carotid artery dissection (ICAD) is an uncommon but clinically significant cause of ischemic stroke in young adults, accounting for approximately 10%-25% of cases in this population. It is frequently associated with minor trauma or repetitive cervical movements. Headbanging, characteristic of heavy metal music performances, involves vigorous, repetitive movements of the head and neck and may increase the risk of cervical vascular injury, including ICAD.Case report
A 37-year-old male musician with no prior neurological disease presented with severe headache and transient focal neurological symptoms following heavy metal performances involving headbanging. On examination, blood pressure was 130/80 mmHg, and no focal neurological deficits were observed (NIHSS score: 0). Computed tomography angiography demonstrated a subocclusive thrombus involving the distal cervical and petrous segments of the left internal carotid artery, with distal hypoperfusion. Digital subtraction angiography subsequently confirmed a left ICAD of the petrous segment with approximately 80% luminal stenosis. Management included anticoagulation with dabigatran, strict blood pressure control, and multidisciplinary follow-up, including psychological support. The patient was discharged with guidance to avoid abrupt cervical movements and to continue regular outpatient and imaging follow-up.Discussion
Although uncommon, the association between headbanging and ICAD warrants consideration in young patients presenting with ischemic stroke in the absence of traditional cardiovascular risk factors. Repetitive, forceful cervical movements may cause arterial wall injury, predisposing to dissection. Early diagnosis is essential to guide appropriate management and prevent complications.Conclusion
This case highlights the importance of recognizing activities involving repetitive, vigorous cervical movements, such as headbanging, as potential etiological factors for arterial dissection in young adults. The absence of follow-up imaging is a limitation of this case report; nonetheless, it remains useful in raising awareness that may facilitate earlier diagnosis and improve clinical outcomes.
Related
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- A ruptured internal carotid artery blood blister-like aneurysm with rebleeding after single-layer neck-bridging stenting and complete obliteration after double-layer stenting: A case report.
BibTeX
@article{cidral2026left,
title = {{Left Internal Carotid Artery Dissection Secondary to Minor Trauma: A Case Report Involving "Headbanging" in a Heavy Metal Band.}},
author = {Louissa Srama Rosner Cidral and Eduarda Nakoula and Kristel Back Merida and Ana Carolina Andrade and Luiz Penzo and Leonardo Gilmone Ruschel},
journal = {Case reports in vascular medicine},
year = {2026},
month = oct,
doi = {10.1155/crvm/9589977},
url = {https://europepmc.org/article/MED/42948319},
note = {CC BY},
}
RIS
TY - JOUR
TI - Left Internal Carotid Artery Dissection Secondary to Minor Trauma: A Case Report Involving "Headbanging" in a Heavy Metal Band.
AU - Louissa Srama Rosner Cidral
AU - Eduarda Nakoula
AU - Kristel Back Merida
AU - Ana Carolina Andrade
AU - Luiz Penzo
AU - Leonardo Gilmone Ruschel
PY - 2026
DA - 2026/10/27
JO - Case reports in vascular medicine
DO - 10.1155/crvm/9589977
UR - https://europepmc.org/article/MED/42948319
AB - Introduction Internal carotid artery dissection (ICAD) is an uncommon but clinically significant cause of ischemic stroke in young adults, accounting for approximately 10%-25% of cases in this population. It is frequently associated with minor trauma or repetitive cervical movements. Headbanging, characteristic of heavy metal music performances, involves vigorous, repetitive movements of the head and neck and may increase the risk of cervical vascular injury, including ICAD.Case report A 37-year-old male musician with no prior neurological disease presented with severe headache and transient focal neurological symptoms following heavy metal performances involving headbanging. On examination, blood pressure was 130/80 mmHg, and no focal neurological deficits were observed (NIHSS score: 0). Computed tomography angiography demonstrated a subocclusive thrombus involving the distal cervical and petrous segments of the left internal carotid artery, with distal hypoperfusion. Digital subtraction angiography subsequently confirmed a left ICAD of the petrous segment with approximately 80% luminal stenosis. Management included anticoagulation with dabigatran, strict blood pressure control, and multidisciplinary follow-up, including psychological support. The patient was discharged with guidance to avoid abrupt cervical movements and to continue regular outpatient and imaging follow-up.Discussion Although uncommon, the association between headbanging and ICAD warrants consideration in young patients presenting with ischemic stroke in the absence of traditional cardiovascular risk factors. Repetitive, forceful cervical movements may cause arterial wall injury, predisposing to dissection. Early diagnosis is essential to guide appropriate management and prevent complications.Conclusion This case highlights the importance of recognizing activities involving repetitive, vigorous cervical movements, such as headbanging, as potential etiological factors for arterial dissection in young adults. The absence of follow-up imaging is a limitation of this case report; nonetheless, it remains useful in raising awareness that may facilitate earlier diagnosis and improve clinical outcomes.
SN - 2090-6986
SN - 2090-6994
ER -