Traumatic Carotid Artery Dissection Following a Brazilian Jiu-Jitsu Chokehold: A Case Report.

Carotid artery dissection is a rare but important cause of stroke in young adults, often resulting from trauma rather than atherosclerotic disease. This case describes a previously healthy 37-year-old male who experienced a sudden onset of left facial and arm numbness and weakness during exercise, shortly after participating in a Brazilian Jiu-Jitsu (BJJ) session. A chokehold maneuver one week earlier was identified as a likely precipitating factor. Initial symptoms resolved within an hour, but imaging a week later revealed a right internal carotid artery dissection with a small cortical infarct in the right insula. He was treated conservatively with aspirin, and follow-up imaging showed complete vessel healing. This case highlights the delayed and subtle presentation of carotid artery dissection following neck trauma in grappling sports. The mechanism typically involves vascular compression and neck hyperextension, resulting in intramural hematoma and potential thromboembolism. Timely diagnosis through detailed history-taking and vascular imaging is crucial to prevent stroke. Additionally, similar vascular injuries can result from non-fatal strangulation in assault or domestic violence, which may go unrecognized due to absent external signs. Clinicians should maintain a high index of suspicion for carotid dissection in young patients with acute neurological symptoms and recent neck trauma, regardless of mechanism.