J Neurol Neurosurg Psychiatry 71:704-705 doi:10.1136/jnnp.71.5.704
  • Lesson of the month

An unexpected consequence of a roller coaster ride

  1. K Lascellesa,
  2. D Hewesa,
  3. V Ganesanb
  1. aGuys Hospital, Newcomen Centre, London SE1 9RT, UK, bNeurosciences Unit, Institute of Child Health, University College London,London, UK
  1. : Dr KP Lascelles karine.lascelles{at}
  • Received 21 March 2001
  • Accepted 25 May 2001

Cervicocephalic arterial dissections are an important cause of stroke in young people with potential treatment implications. They are implicated in the aetiology of about 5% of ischaemic strokes in the paediatric age group.1-2 Recognition is often delayed because the clinical symptoms (headache and neck pain) are non-specific and the diagnosis may not be considered until there is evidence of neurological impairment. Furthermore, the diagnosis may be missed unless targeted investigations are carried out. This may adversely affect the clinical course.

Case report

An 11 year old boy was taken to an amusement park during the school holidays. Towards the end of the day, he went on a roller coaster ride. The ride came to a sudden stop and he immediately experienced a generalised headache, which lasted 1 week. He was then well enough to go to another amusement park, where he enjoyed several other rides. Over the …

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