Ludwig Schlemm1,2,3,4, Christian H Nolte1,2, Stefan T Engelter5,6, Matthias Endres1,2,3,7,8, Martin Ebinger1,2,9. 1. Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany. 2. Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Berlin, Germany. 3. Berlin Institute of Health (BIH), Berlin, Germany. 4. London School of Economics and Political Science, London, UK. 5. Stroke Center and Department of Neurology, University Hospital Basel and University of Basel, Switzerland. 6. Neurorehabilitation Unit, University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, University of Basel, Basel, Switzerland. 7. DZHK (German Center for Cardiovascular Research), Partner Site, Berlin, Germany. 8. DZNE (German Center for Neurodegenerative Diseases), Partner Site, Berlin, Germany. 9. Department of Neurology, MEDICAL PARK Berlin Humboldtmühle, Berlin, Germany.
Abstract
INTRODUCTION: Cervical artery dissections may be preceded by mechanical trigger events, often related to sports. METHODS: Using the MEDLINE database, we identified case reports and case series of sports-related cervical artery dissections. Information of the type of sport, age and gender of the patient, affected vessels, associated infarction, time delay, and neurological sequelae were extracted. Demographic and clinical characteristics were compared between sport groups using analysis of variance and Chi square tests. Differences were further assessed with adjusted post hoc tests and homogenous subsets. RESULTS: A total of 115 reports describing 190 patients with cervical artery dissections related to 45 different sports were identified. The mean age of all patients was 35 years; 26% of all patients were women. Anterior and posterior circulation, as well as left and right side were affected with similar frequency. Patients belonging to different sport categories differed significantly with regard to age (p < 0.001), gender (p < 0.001), and affected circulation (anterior vs. posterior, p = 0.02). The posterior circulation was most often affected in golf players (88%) and least often in individuals engaging in exercise (23%) and scuba divers (29%). Laterality (left vs. right) and mortality were similar between sport groups. DISCUSSION: We performed a comprehensive review and analytical evaluation of case reports describing patients with cervical artery dissections after sport. Confirmation of our findings in prospective studies is needed. CONCLUSION: Cervical artery dissection has been described in relation to a wide variety of sports. The risk of injury to particular neurovascular structures may depend on the type sport involved. Discipline-specific incidence rates are not known.
INTRODUCTION: Cervical artery dissections may be preceded by mechanical trigger events, often related to sports. METHODS: Using the MEDLINE database, we identified case reports and case series of sports-related cervical artery dissections. Information of the type of sport, age and gender of the patient, affected vessels, associated infarction, time delay, and neurological sequelae were extracted. Demographic and clinical characteristics were compared between sport groups using analysis of variance and Chi square tests. Differences were further assessed with adjusted post hoc tests and homogenous subsets. RESULTS: A total of 115 reports describing 190 patients with cervical artery dissections related to 45 different sports were identified. The mean age of all patients was 35 years; 26% of all patients were women. Anterior and posterior circulation, as well as left and right side were affected with similar frequency. Patients belonging to different sport categories differed significantly with regard to age (p < 0.001), gender (p < 0.001), and affected circulation (anterior vs. posterior, p = 0.02). The posterior circulation was most often affected in golf players (88%) and least often in individuals engaging in exercise (23%) and scuba divers (29%). Laterality (left vs. right) and mortality were similar between sport groups. DISCUSSION: We performed a comprehensive review and analytical evaluation of case reports describing patients with cervical artery dissections after sport. Confirmation of our findings in prospective studies is needed. CONCLUSION: Cervical artery dissection has been described in relation to a wide variety of sports. The risk of injury to particular neurovascular structures may depend on the type sport involved. Discipline-specific incidence rates are not known.
Authors: Samuel J Stellpflug; William Weber; Ann Dietrich; Brian Springer; Robin Polansky; Carolyn Sachs; Antony Hsu; Sarayna McGuire; Casey Gwinn; Gael Strack; Ralph Riviello Journal: J Am Coll Emerg Physicians Open Date: 2022-04-16
Authors: Ludwig Schlemm; Regina von Rennenberg; Eberhard Siebert; Georg Bohner; Fabian Flottmann; Gabor C Petzold; Götz Thomalla; Matthias Endres; Christian H Nolte Journal: Neurol Res Pract Date: 2021-05-03
Authors: Elizabeth Lounsbury; Brian Dewar; Alexandra Davis; Dean A Fergusson; Dar Dowlatshahi; Michel Shamy Journal: BMJ Open Date: 2020-09-13 Impact factor: 2.692