Roller coaster headaches revisited

doi:10.1016/S0090-3019(03)00296-9

Surgical Neurology

Volume 60, Issue 5, November 2003, Pages 398-401

https://doi.org/10.1016/S0090-3019(03)00296-9 Get rights and content

Abstract

Background

Roller coasters are probably one of the more popular rides at amusement parks around the world. Despite their relative safety, nontraumatic intracranial injuries have been reported following roller coaster rides. The presence of an intracranial arachnoid cyst may increase the risk of nontraumatic injury in this setting.

Case description

We describe a 33-year-old female with a left middle fossa arachnoid cyst who presented with increasing headaches from bilateral subdural hygromas after a roller coaster ride. The patient underwent bilateral burr hole drainage of her subdural hygromas with resolution of her symptoms.

Conclusion

This case demonstrates the potential risks of intracranial injury in patients with an underlying arachnoid cyst who engage in certain types of recreational activity.

Section snippets

Case report

A 33-year-old, right-handed female with no significant past medical history developed severe headaches after a roller coaster ride 1 week before presentation. She experienced nausea and vomiting over the past 24 hours. She denied any recent or prior falls or blows to the head or any recent fevers. A CT scan of the head revealed bilateral subdural hygromas and a left temporal arachnoid cyst (Figure 1). Neurologic examination was nonfocal, and there was no evidence of papilledema. A lumbar

Discussion

Hemorrhagic complications of arachnoid cysts have been well described and are frequently associated with trauma 1, 2, 5, 8, 14, 16, 18, 21, 22, 25, 26, 32, 34, 36, 38. Rupture of a middle fossa arachnoid cyst causing acute subdural hygromas is less common 1, 6, 7, 8, 9, 17, 28, 31, 37.

Roller coasters are popular attractions at amusement parks around the world and are ridden by thousands of individuals every year. Review of the literature reveals several case reports of intracranial injury

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Spontaneous chronic subdural hematoma in a 22-year-old healthy woman
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Citation Excerpt :
The more subtle cases, however, are those attributed to an activity involving rotational head and neck accelerations such as those experienced by the patient in this case. In the literature, similar occurrences have been reported in young individuals riding a rollercoaster (7, 10, 15, 23, 25), head-shaking at rock concerts (4, 14, 22), breakdancing (21), or bungee cord jumping (8). These are situations of indirect head trauma and might not be determined from history questions, especially if the patient is only asked whether or not they have hit their head recently.
Chronic subdural hematoma is a common presentation to the neurosurgical practice that tends to occur among the elderly.
We identify a rare occurrence of a chronic subdural hematoma in a young and otherwise healthy female patient who denied a traumatic brain injury.
Upon reviewing the literature, we found only one reported case of a spontaneous nature in a young patient. The subtle presentation of headaches and absence of neurological deficit could be mistaken as migraine and result in a delay in obtaining imaging and necessary treatment. In this report, we present a 22-year-old patient who complained of persistent headaches and was neurologically intact on examination. Cranial computed tomography revealed the presence of a right-sided chronic subdural hematoma; this was followed by magnetic resonance imaging plus angiogram, which ruled out the presence of a vascular abnormality. A burr-hole craniostomy procedure was used that resulted in resolution of symptoms.
Without a heightened clinical suspicion, a similar presentation could be missed, resulting in delayed management.
Pulmonary hemorrhage resulting from roller coaster
2011, American Journal of Emergency Medicine
The Postconcussion Syndrome
2008, Neurology and General Medicine
The Postconcussion Syndrome
2007, Neurology and General Medicine: Expert Consult
Subdural hematoma in a teenager related to roller-coaster ride
2006, European Journal of Paediatric Neurology
Reports about neurological injury related to roller-coaster rides mostly involve adults; we present a case of subdural hematoma in a pediatric patient presented 14 days after a roller-coaster ride. These rides show extreme up-and-down, to-and-fro, and rotatory acceleration/deceleration forces that could produce tensile and shearing stresses with tearing of bridging cerebral veins resulting in subdural hemorrhage.
Pediatricians should consider roller-coaster riding a modern cause of subdural hematoma, as well as a possible cause of unexplained neurologic events in otherwise healthy adolescents.
Roller Coaster-Induced Subdural Hematoma in a Previously Healthy Teenager
2019, Pediatric Emergency Care

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TraumaRoller coaster headaches revisited

Abstract

Background

Case description

Conclusion

Section snippets

Case report

Discussion

Brain Dev

Surg Neurol

Surg Neurol

Lancet

Am J Med

Arachnoid cyst rupture producing subdural hygroma and intracranial hypertensioncase reports

Neurosurgery

Diagnosis and treatment of middle fossa arachnoid cysts and subdural hematomas

J Neurosurg