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Question: I suffer from an anxiety disorder and haven't been moving around very much, a couple weeks ago, after a very intense work out in my karate class, I turned my head and felt a weird sensation where I couldn't move my neck. My boss rubbed on the spot that hurt as a way to help for a couple minutes. The next day I was very stiff and sore but was fine by saturday. That weekend, I spent the entire day vacuuming my inground pool which was a long period of looking down, about 3-6 hours. On monday, about a half hour after I woke, my neck became very stiff again but worse this time. I couldn't lean my head back or to either side. The pain is strong on the back of my neck and on the right of my neck. I also have what feels like a lymph node in a few spots on the right of my neck and right above my collar bone (I'm not sure if this is the artery or not) there is a small, fixed lump that is hard. I should also add that I get a splitting headache up the side and back of my head. Also my right shoulder is in pain as well, and sometimes feels like it's being ripped out of my socket. Going back to vertebral artery dissection, I know you can develop a stroke from it and knowing so caused me to panic and a few days ago I went to the hospital. They ruled out a stroke, but now I feel even worse. Last night, I could barely feel one side of my body and I was afraid to go to sleep. I finally did, but today as been a day from hell. My hands and feet are both tingling, as my arms and legs feel so very sore like there's no muscle. The right side of my neck, that I originally injured is really hard and I just feel like my cognitive skills are being affected because even my mouth feels weird. My eyes feel very tired and my head is killing me, mostly in the back of my head but the sharp pain shoots up. I honestly feel like I can't even walk my body feels so weak. I'm honestly scared and I don't know if it is my anxiety, because that can be a real factor. I also just cleaned out my ears and out of my right ear (again, the side I injured my neck) was spots of blood. Should I go to the hospital? Should I try to relax? I'm truly scared at this point.
Brief Answer:
Anxiety the main culprit.
Detailed Answer:
I read your question as well as the other queries you have made carefully. It is obvious that you are feeling very distressed due to this issue and I am sorry about that.
I must say that (fortunately) I agree with my colleagues in saying that there is no brain or spinal cord lesion. That constellation of symptoms is of a very scattered character which corresponds to no definite stroke lesion. As for the spots you feel to be palpating I can assure you that you can not palpate your vertebral artery, it traverses through a hole in the vertebral arches, so sort of inside a bony canal with muscles on top of it, so even had there been a dissection you wouldn't be able to touch it. The blood from the ear is not related to stroke or dissection either, since CT hasn't evidenced any ear issue must be due to local trauma during the cleaning act.
The rest of the symptoms as I said are too wide spread to be related to a one specific cause and I believe to be related to anxiety. I am not saying that every symptom is related to anxiety, some of the pain is related to muscle spasm you were told about and it can irradiate towards your back of the head and shoulder. Anxiety however is multiplying your perception of those symptoms and causing new ones like the tingling, weakness etc.
So you should definitely try to relax, take some over the counter pain killers and muscle relaxants for the pain. If persistent you should consult the doctor who diagnosed anxiety disorder preferably a psychiatrist or neurologist, psychotherapy and some adjustment in the therapy can be made.
I remain at your disposal for other questions.
Anxiety the main culprit.
Detailed Answer:
I read your question as well as the other queries you have made carefully. It is obvious that you are feeling very distressed due to this issue and I am sorry about that.
I must say that (fortunately) I agree with my colleagues in saying that there is no brain or spinal cord lesion. That constellation of symptoms is of a very scattered character which corresponds to no definite stroke lesion. As for the spots you feel to be palpating I can assure you that you can not palpate your vertebral artery, it traverses through a hole in the vertebral arches, so sort of inside a bony canal with muscles on top of it, so even had there been a dissection you wouldn't be able to touch it. The blood from the ear is not related to stroke or dissection either, since CT hasn't evidenced any ear issue must be due to local trauma during the cleaning act.
The rest of the symptoms as I said are too wide spread to be related to a one specific cause and I believe to be related to anxiety. I am not saying that every symptom is related to anxiety, some of the pain is related to muscle spasm you were told about and it can irradiate towards your back of the head and shoulder. Anxiety however is multiplying your perception of those symptoms and causing new ones like the tingling, weakness etc.
So you should definitely try to relax, take some over the counter pain killers and muscle relaxants for the pain. If persistent you should consult the doctor who diagnosed anxiety disorder preferably a psychiatrist or neurologist, psychotherapy and some adjustment in the therapy can be made.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much. Now as a follow up, I have a rather strange question. I feel like my cognitive skills are weakening, such as I feel confused rather easily or like I'm "out of it," my brain just doesn't feel up to par lately and I don't know if that has to do with the fact that I'm very weak in the muscles of my neck or what, but while I talk fine and can type as well as usual, I have this feeling that I'm weaker than usual. Like I get stuck. It's all so very confusing, and I don't know if that is part of my anxiety (it never has been) because I have been so worried about having a stroke and knowing that a stroke can affect those types of skills. Is that possible?
Brief Answer:
Read below.
Detailed Answer:
Cognitive skills are a subjective affair, in order to say that there is a cognitive impairment it must be proven through objective neuropsychological testing, standardized test to evaluate different components of cognition.
That being said anxiety is one of the most common confounders as it has been proven to affect concentration which is what I believe to be your case.
Anyway even if there was a chance my impression was wrong I am confident that it is not the case because you have had a CT scan. A stroke sizable enough to affect your cognitive skills would have definitely been visible on CT.
Also since your biggest worry is a vertebral artery dissection causing a stroke, if that was the case it still wouldn't affect cognition as the stroke would affect the posterior areas, the brain stem and little brain, while cognitive functions are related to the anterior brain cortex which isn't supplied by the vertebral arteries.
I hope that serves to reassure you.
Read below.
Detailed Answer:
Cognitive skills are a subjective affair, in order to say that there is a cognitive impairment it must be proven through objective neuropsychological testing, standardized test to evaluate different components of cognition.
That being said anxiety is one of the most common confounders as it has been proven to affect concentration which is what I believe to be your case.
Anyway even if there was a chance my impression was wrong I am confident that it is not the case because you have had a CT scan. A stroke sizable enough to affect your cognitive skills would have definitely been visible on CT.
Also since your biggest worry is a vertebral artery dissection causing a stroke, if that was the case it still wouldn't affect cognition as the stroke would affect the posterior areas, the brain stem and little brain, while cognitive functions are related to the anterior brain cortex which isn't supplied by the vertebral arteries.
I hope that serves to reassure you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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