Roller Coaster Triggered Stroke in Child | News | Loyola Medicine
Thursday, December 11, 2014

Roller coaster rides triggered stroke in 4-year-old, researchers report

MAYWOOD, Ill. (December 11, 2014) – Riding a couple of roller coasters at an amusement park appears to have triggered an unusual stroke in a 4-year-old boy, according to a report in the journal Pediatric Neurology.

The sudden acceleration, deceleration and rotational forces on the head and neck likely caused a tear in the boy’s carotid artery. This tear, called a dissection, led to formation of a blood clot that triggered the stroke, Loyola University Medical Center neurologist José Biller, MD, and colleagues report.

Strokes previously have been reported in adult roller coaster riders, but there are only a few previous reports of strokes in children who rode roller coasters, including a 13-year-old girl and an 11-year-old boy. The 4-year-old boy described by Loyola neurologists is one of the youngest reported in the medical literature.

Prior to his stroke, the 4-year-old boy was healthy. During an out-of-state vacation with his parents, he rode two roller coasters. The first ride was 679 feet long and 30 feet high, with a top speed of 25 mph. The second ride had a 53-foot drop with a descent speed of 40 mph.

The day after riding the roller coasters, the boy vomited and developed a droop on the left side of his face while on the flight back home. By the time he arrived home, he was unable to walk and had weakness on his left side. He was rushed to the hospital, where imaging exams showed he had experienced a carotid artery dissection and stroke. He received low-dose aspirin and doctors observed a steady improvement. At a six-month follow-up visit, his gait had improved considerably, and he had only mild muscle weakness and stiffness on the left side.

Sudden movements that can hyperextend the neck or rotate the neck – such as whiplash, certain sports movements or even violent coughing  – can result in a dissection of the carotid artery. A dissection begins as a tear in one layer of the artery wall. A blood clot can form in the area of the tear. If it’s large enough, the clot can block blood flow to the brain. Or pieces of the clot can break free, travel up to the brain and block blood flow to the brain. In either case, the result is a stroke.

A child under age 10 is vulnerable to sudden neck movements and rotations due to weak neck muscles, a relatively large head and other factors.

“This hypermobility, combined with other kinetic and linear forces experienced during a roller coaster ride, could theoretically explain why some children, albeit rarely, sustain dissections,” Dr. Biller and colleagues wrote.

Dr. Biller is an internationally known expert on strokes in children and young adults. He has written a textbook on the topic and is a co-author of the American Heart Association’s guidelines for management of stroke in infants and children. Dr. Biller notes that about 15 percent of the most common type of strokes (caused by blood clots) occur in adolescents and young adults.

Dr. Biller is chair of the Department of Neurology of Loyola University Chicago Stritch School of Medicine.

The paper in Pediatric Neurology is titled “Internal carotid artery dissection after a roller-coaster ride in a 4-year-old. Case Report and Review of the Literature.” Co-authors are first author Amre Nouh, MD; Daniel Vela-Duarte, MD; Thomas Grobelny, MD; George Hoganson, MD; and David Pasquale, MD.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 92 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 129,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.