Thrombosis of the internal jugular vein is a relatively rare condition that can be induced by a variety of mechanical injuries.^1,2 Acupressure, or “shiatsu”, is an oriental massage technique and many acupoints on the body surface, known as “tsubos”, are used for shiatsu. Shiatsu of tsubos in the nape of the neck is known to improve tension headache due to neck and shoulder aches. However, we recently came across a case of internal jugular vein (IJV) and cerebral sinus thrombosis after shiatsu massage of the neck.

Case report

A 35 year old man, a non-smoker, was suffering from a stiff neck. He consulted a shiatsu masseur, who performed shiatsu massage on the right side of his neck and right shoulder for 30 minutes. Immediately after the shiatsu massage, the patient noticed pain and swelling of the right side of the neck, both of which subsided within seven days. Two days after the shiatsu massage, he developed a severe, constant right occipital headache and consulted his attending physician. His cervical radiograph was normal. The patient continued to have severe headache, however, and on the seventh day after the massage, he developed blurred vision. On the twentieth day, he developed weakness and paraesthesia of his right arm and leg, and mild agraphia for kanji characters. When he also developed focal motor seizure, he was admitted to our hospital. He underwent …