Worried of another artery dissection
32F, 165cm, 62kgs, taking Nurtec every other day and fluoxetine every day. History of vertebral artery dissection September 2025, chronic migraines, TMJ ostheoartritis, hypermobile (root of all my issues).
Last tuesday I had TMJ PT due to an arthrocentesis. PT gave me a neck massage on the platisma and other parts of neck.
Last wednesday I had my usual botox migraine protocol injected (every 6 months).
Yesterday I started having intense pain just under the ear and down the “platisma”, or somewhere there. It was very intense, and I felt Ill. I’ve had headaches but since I take Nurtec i have them under control. Though lately I’ve been having tons of migraines, that’s why I needed my botox session.
Now it’s 4am here (Chile) and I woke up with intense pain in that same area, in the right side of my neck, and it’s palpably swollen. I’m afraid of could be dissection, not vertebral artery of course, but maybe carotid? Not sure if i would feel pain in that spot.
I’m only familiar with VAD pain, and it was kinda like this in the way that it seemsd muscular, but not quite, and put heat on it thinking it would make it better but didn’t. Last VAD was also due to PT massage (crazy) so that’s why i’m scared. Is this a possibility or what could this be? Should I need to go to the ER?