Preferential Location for Arterial Dissection Presenting as Golf-Related Stroke

Abstract

SUMMARY:Golf-related stroke has not been systematically reviewed. The purpose of our study was to describe in detail this particular stroke syndrome. Seven patients were analyzed at a university hospital and 7 patients were reviewed from MEDLINE literature. General demographics, symptom onset, neurologic signs, radiologic findings, and outcome were investigated. A total of 14 patients including 7 patients from the MEDLINE search were analyzed; all were men, with a mean age of 46.9 Ϯ 12.8 years. Symptom onset was classified as during the golf swing (n ϭ 9), unknown (n ϭ 3), and after playing golf (n ϭ 2). Most patients (n ϭ 12) showed involvement of the vertebral artery and 2 patients showed involvement of the internal carotid artery (P ϭ .008). Nine dissections were found on the right side, 3 on the left side, and 2 were bilateral (P ϭ .046). Twelve patients had extracranial involvement and 2 patients had intracranial involvement (P ϭ .008). Seven patients returned to normal, 5 returned to independence, 1 had unknown status, and 1 died. The anatomic preference of golf-related craniocervical arterial dissection is associated with the extracranial and vertebrobasilar system with a right-sided tendency as the result of stereotypical rotational movement during a golf swing. ABBREVIATION: VA ϭ vertebral artery

Cervical artery dissection after sports – An analytical evaluation of 190 published cases

“…The site of vascular injury may vary according to the type of sport. For example, as noted previously by Choi et al, 57 golfers tend to have CAD in the posterior rather than in the anterior circulation and predominantly on the right side. The authors suggest that rotational forces on the vertebral arteries that occur during the swing may be responsible for this observation.…”

Chemical Meningitis after a Golf Swing-induced Dermoid Cyst Rupture

“…Head movements and even brain pulsations, such as the hammer-like actions, have been suggested as probable actions that cause a spontaneous dermoid cyst rupture (6). Golf-swings are high-speed, forceful, rotational movements of the head and body, with a prominent shift of body-weight (7). However, amateur golfers tend to show a vertical head movement, such as the head-down movement, during the downward swing, and an early head-up movement while hitting the ball (8).…”

Extracranial Vertebral Artery Aneurysm: An Unpleasant Consequence of Neck Massage

“…[ 1 ] Usually, the dissection takes place at the most mobile and unprotected segment of the VA – the atlantal segment (between transverse foramen of C2 and till it enters the dura). [ 3 ] The history our patient gave would suggest that initial passive forcible neck movements during massage led to a VA dissection from which he recovered and later presented with an expanding extracranial VA pseudoaneurysm resulting in C2 root compression and occipital neuralgia as well as the neck mass.…”

“…Treatment modalities include excision of the aneurysm with ligation of the parent vessel,[ 1 2 5 ] excision with repair of the VA,[ 5 6 ] arterial bypass with trapping of the aneurysm and excision,[ 2 6 ] stenting the vessels,[ 5 ] embolization of the aneurysm[ 3 ] or parent vessel,[ 2 5 ] and flow diverters. [ 5 ] Of these, ligation of the VA is the most common procedure undertaken if the contralateral VA is patent.…”