title: Roller coaster-associated subarachnoid hemorrhage--report of 2 cases.
abstract: The most common neurological injuries associated with roller coaster rides are subdural hematoma and cervical artery dissection. We report two cases of roller-coaster associated subarachnoid hemorrhage (SAH). A 40-year-old healthy man developed a strong, holocephalic headache during a roller coaster ride. SAH Hunt & Hess grade II and Fisher grade 3 was diagnosed. An underlying aneurysm of the anterior communicating artery was successfully treated with coil embolization. A 41-year-old female (smoker, otherwise healthy) experienced a sudden, strong headache and diplopia during a roller coaster ride. A perimesencephalic SAH (Hunt & Hess grade II, Fisher grade 3) was disclosed by a CT scan. No aneurysm was detected on angiography. Both patients were discharged without neurological disability. In conclusion, SAH is a rare but relevant differential diagnosis in cases of acute headache during roller coaster rides. Both aneurysmal and non-aneurysmal perimesencephalic SAH can occur. A combination of mechanical factors and excessive blood pressure rises in vulnerable persons is discussed.
authors.affiliation: Department of Neurology, University of Freiburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rutsch
authors.forename: Wolf-Dirk
authors.initials: WD
authors.lastname: Niesen
authors.forename: Stephan
authors.initials: S
authors.lastname: Meckel
authors.forename: Matthias
authors.initials: M
authors.lastname: Reinhard
mesh_terms: D000328:Adult; D005260:Female; D019416:Head Movements / Q000502:physiology; D006261:Headache / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007899:Leisure Activities; D008297:Male; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology