title: Three cases of cervicocephalic artery dissection in an amusement park.
abstract: 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.
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan.
authors.forename: Naohide
authors.initials: N
authors.lastname: Kurita
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan. Electronic address: yuji-u@juntendo.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Miyamoto
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimura
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Japan.
authors.forename: Senshu
authors.initials: S
authors.lastname: Nonaka
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Japan.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Yasumoto
authors.affiliation: Department of Neurology, Juntendo University School of Medicine, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.affiliation: Department of Neurology, Juntendo University Urayasu Hospital, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
mesh_terms: D000328:Adult; D020215:Carotid Artery, Internal, Dissection / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002533:Cerebral Angiography / Q000379:methods; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006112:Gravitation; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D018810:Magnetic Resonance Angiography; D008297:Male; D011237:Predictive Value of Tests; D011998:Recreation; D012307:Risk Factors; D012420:Running; D013314:Stress, Mechanical; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
keywords: amusement park; amusement park stroke; cervicocephalic artery dissection; stroke