Kurita Naohide, Ueno Yuji, Watanabe Masao, Miyamoto Nobukazu, Shimura Hideki, Nonaka Senshu, Tsutsumi Satoshi, Yasumoto Yukimasa, Hattori Nobutaka, Urabe Takao
Department of Neurology, Juntendo University Urayasu Hospital, Japan.
Department of Neurology, Juntendo University Urayasu Hospital, Japan.
J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):e467-e471. doi: 10.1016/j.jstrokecerebrovasdis.2014.07.024. Epub 2014 Sep 26.
About 20 cases of cerebrovascular accidents in amusement parks have been documented. However, only a few cases of amusement park stroke (APS) after roller coaster rides have been reported. Here, we present triggers of stroke, clinical characteristics, and the angiographic appearance of 3 consecutive patients of APS. Their clinical characteristics included young age, absence of atherosclerotic risk factors, and severe injuries. Serial changes in angiographic appearance led to the diagnosis of cervicocephalic artery dissection (CAD). Patients A and B were diagnosed with isolated middle cerebral artery (MCA) dissection, and patient C was diagnosed with internal carotid artery dissection involving MCA dissection. Running excitedly toward an attraction in patient A, a go-kart ride in patient B, and riding in an enhanced motion vehicle in patient C were considered as the likely triggers for APS. We had specific cases with APS associated with CAD, which can occur under diverse contexts other than roller coaster rides at amusement parks. Our findings suggest that the variable directions of the high gravitational forces induced by vehicle riding or running excitedly might injure the MCA or internal carotid artery, and thereby cause CAD in the amusement park.
已有文献记载约20例发生在游乐园的脑血管意外事件。然而,仅有少数过山车乘坐后发生游乐园卒中(APS)的病例报告。在此,我们介绍3例连续的APS患者的卒中诱因、临床特征及血管造影表现。他们的临床特征包括年轻、无动脉粥样硬化危险因素以及严重损伤。血管造影表现的系列变化导致诊断为头颈动脉夹层(CAD)。患者A和B被诊断为孤立性大脑中动脉(MCA)夹层,患者C被诊断为累及MCA夹层的颈内动脉夹层。患者A兴奋地跑向一个游乐设施、患者B乘坐卡丁车、患者C乘坐增强动感车辆被认为是APS的可能诱因。我们有与CAD相关的APS的特定病例,其可发生在游乐园过山车乘坐以外的多种情况下。我们的研究结果表明,乘车或兴奋奔跑所产生的高重力的可变方向可能会损伤MCA或颈内动脉,从而在游乐园导致CAD。