Claudia Mason never imagined whipping her head around dancing could put her at risk of a stroke.
But the neck soreness the New York-based model and actress experienced after a dance class during which she threw her head around “à la Beyoncé,” was actually a symptom of cervical dissection (CD), or a tear in her vertebral artery.
When an artery is injured, a blood clot forms to “heal” the injury. In Mason’s case, that blood clot became dislodged, blocking the blood flow to the brain, causing an ischemic stroke.
“I never thought something like this could happen to a healthy younger adult in a dance class,” Mason said. “I always thought strokes were something only seniors citizens with heart disease had.”
A new scientific statement published Thursday by the American Heart Association and American Stroke Association says neck traumas like the one Mason experienced, and treatments that involve neck manipulations provided by some health practitioners, may be associated with stroke. Even neck pain alone could be a symptom of the beginning of a cervical dissection.
“Most dissections involve some trauma, stretch or mechanical stress,” said José Biller, M.D., lead author of the statement and professor and chair of neurology at the Loyola University Chicago Stritch School of Medicine. “Sudden movements that can hyperextend or rotate the neck — such as whiplash, certain sports movements, or even violent coughing or vomiting — can result in CD, even if they are deemed inconsequential by the patient.”
According to the findings, it cannot be said with certainty that neck manipulation causes strokes and a cause-and-effect relationship has not been established between neck manipulation therapies - which can include maneuvers in which health practitioners extend and rotate the neck and sometimes involve a forceful thrust - and CD. The risk is probably low, but CD can result in serious neurological injury, Biller said. “Patients should be informed of this association before undergoing neck manipulation.”
Patients should seek emergency medical evaluation if they develop neurological symptoms after neck manipulation or trauma, such as pain in the back of their neck or in their head, dizziness/vertigo, double vision, unsteadiness when walking, slurred speech, nausea and vomiting, and jerky eye movements.
"Tell the physician if you have recently had a neck trauma or neck manipulation," Biller said. "Some symptoms, such as dizziness or vertigo, are very common and can be due to minor conditions rather than stroke, but giving the information about recent neck manipulation can raise a red flag that you may have a CD rather than a less serious problem, particularly in the presence of neck pain."
Stroke is the No. 4 cause of death and a leading cause of disability in the United States and cervical dissection (CD), the name for tears in the layers of artery walls in the neck, is an important cause of stroke in young and middle aged adults.
Mason, who is in her early 40s, didn’t think twice about the soreness in her neck following her dance class. It was her regular Tuesday night dance class and her body was a little sore all over.
It wasn’t until the next day while on her way to an audition in midtown Manhattan that the model and actress experienced a sudden and strange headache. The pain was so intense, Mason sat down immediately to rest on a busy lobby staircase. She closed her eyes and rested her head in her hands, thinking it was possibly a migraine. When she opened her eyes, her vision faltered, and she saw rainbow colored lights as her sight came in and out. These could also be signs of a stroke and the first action should be to call 9-1-1.
With the help of a passerby, Mason instead called her dad to pick her up, and, once safely at his apartment, she took aspirin and went to sleep. The next morning, Mason’s vision had improved, but she was still having trouble seeing on her left side.
“At that point, I knew there was a real problem and it was time to get to the hospital,” she said.
Mason’s sudden loss of vision and severe headache are just two of many symptoms of a stroke.
The acronym F.A.S.T. is an easy way to remember the most common sudden signs of stroke. If someone shows any of these symptoms, immediately call 9-1-1 or emergency medical services.
- Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?
- Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
- Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
- Time to call 9-1-1 – If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.
Other stroke symptoms include the sudden vision loss and headache that Claudia experienced, but also sudden numbness or weakness of the leg, arm or face, sudden confusion or trouble understanding, sudden trouble walking, dizziness, and a loss of balance or coordination.
Mason spent six days in the hospital following her stroke as doctors adjusted medication to allow her body to heal. She continues to have a partial visual field deficit on her left from the stroke, which is slowly healing, but didn’t experience any cognitive or muscular disability.
The tear in Mason’s vertebral artery healed after a few months, and she takes only a daily baby aspirin.
The experience has left Mason with a new appreciation for stroke and for listening to her body, and encourages others to seek help if something doesn’t seem right.
“If you’re having unusual and alarming symptoms that aren’t going away and aren’t allowing you to function normally, get medical attention right away,” she said.