Internal carotid artery dissection after a roller coaster ride in a 4-year-old: case report and review of the literature

Pediatr Neurol. 2015 Mar;52(3):349-51. doi: 10.1016/j.pediatrneurol.2014.11.007. Epub 2014 Nov 26.

Abstract

Background: Strokes associated with roller-coaster rides are unusual.

Patient: A previously healthy 4-year-old boy developed acute onset of left-sided weakness when flying home from a trip to an amusement park. He had frequented two roller coaster rides the day prior. Upon evaluation, he was found to have an acute right middle cerebral artery territory infarction.

Results: Cerebral angiography showed dissection of the right cervical internal carotid artery and right middle cerebral artery occlusion involving the M1 segment. He was treated with aspirin. Evaluation for underlying connective tissue diseases was unremarkable.

Conclusion: We speculate that repetitive forces of acceleration and deceleration may have led to a cervical internal carotid artery intimal tear, followed by thromboembolism. It remains uncertain what the threshold of susceptibility to repetitive rotational changes and tolerability to G forces in an otherwise healthy child truly is.

Keywords: amusement park; cervical carotid artery dissection; pediatric strokes; roller coaster.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Athletic Injuries / complications*
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / etiology*
  • Cerebral Angiography
  • Child, Preschool
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Male