Skip to main content
Log in

Stroke in sports: a case series

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Regular physical activity decreases vascular risk. However, vascular events, including stroke, can occur while practicing physical activities. Stroke associated with sports is a rare clinical entity, whose risk factors and mechanisms are not fully understood. We report a case series of sports-related stroke, from tertiary care institutions. From the stroke registries of two University Neurology services and Stroke Units we retrieved all cases of stroke which occurred in temporal association with the practice of sports. Investigators had to fill a simple case report form, describing the demographic, clinical characteristics of the patients and the sport associated with the stroke. We included ten patients aged between 27 and 65 years, 8 being male. Only three subjects had vascular risk factors. Trauma to the head and/or neck was reported in two patients only. Cervicocerebral arterial dissection was the main cause of stroke, occurring in six of the ten cases. No patient died, but three were left disabled (modified Rankin Scale 3–5). This case series confirms that stroke associated with sport is very rare. The majority of the victims did not have vascular risk factors. Dissection was the most common cause of sport-associated stroke. Strokes were often disabling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wendel-Vos GCW, Schuit AJ, Feskens EJM et al (2004) Physical activity and stroke. A meta-analysis of observational data. Int J Epidemiol 33:787–798

    Article  CAS  PubMed  Google Scholar 

  2. Lee C, Do Folsom AR, Blair SN (2003) Physical activity and stroke risk: a meta-analysis. Stroke 34:2475–2481

    Article  PubMed  Google Scholar 

  3. Mostofsky E, Laier E, Levitan EB et al (2010) Physical activity and onset of acute ischemic stroke: the stroke onset study. Am J Epidemiol 173:330–336

    Article  PubMed Central  PubMed  Google Scholar 

  4. Mittleman MA, Mostofsky E (2011) Physical, psychological and chemical triggers of acute cardiovascular events: preventive strategies. Circulation 124:346–354

    Article  PubMed Central  PubMed  Google Scholar 

  5. McCrory P (2009) Neurologic problems in sport. In: Schwellnus MP (ed) Olympic textbook of medicine sport. Wiley-Blackwell, Oxford, UK

  6. McCrory P (2000) Vertebral artery dissection causing stroke in sport. J Clin Neurosci 7:298–300

    Article  CAS  PubMed  Google Scholar 

  7. Giroud M, Chague F, Guard O, Dumas R (1987) Accident vasculaire cérébral ischémique et activité sportive––6 observations. Rev Med Interne 8:373–378

    Article  CAS  PubMed  Google Scholar 

  8. Toth C, McNeil S, Feasby T (2005) Central nervous system injuries in sport and recreation: a systematic review. Sport Med 35:685–715

    Article  Google Scholar 

  9. Noelle B, Clavier I, Besson G, Hommel M (1994) Cervicocephalic arterial dissections related to skiing. Stroke 25:526–527

    Article  CAS  PubMed  Google Scholar 

  10. Bonneton G, Guidicelli H, Benabid A et al (1974) Les traumatismes de I’artere carotide interne au cours des accidents de ski. ChirurgiE 100:255–260

    CAS  PubMed  Google Scholar 

  11. Thanvi B, Munshi SK, Dawson SL, Robinson TG (2005) Carotid and vertebral artery dissection syndromes. Postgrad Med J 81:383–388

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Rubinstein SM, Peerdeman SM, van Tulder MW et al (2005) A systematic review of the risk factors for cervical artery dissection. Stroke 36:1575–1580

    Article  PubMed  Google Scholar 

  13. Ferro JM, Massaro AR, Mas J-L (2010) Aetiological diagnosis of ischaemic stroke in young adults. Lancet Neurol 9:1085–1096

    Article  PubMed  Google Scholar 

  14. Paci M, Nannetti L, D’Ippolito P, Lombardi B (2011) Outcomes from ischemic stroke subtypes classified by the Oxfordshire Community Stroke Project: a systematic review. Eur J Phys Rehabil Med 47:19–23

    CAS  PubMed  Google Scholar 

  15. Adams HP, Bendixen BH, Kappelle LJ et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24:35–41

    Article  PubMed  Google Scholar 

  16. Van Swieten JC, Koudstaal PJ, Visser MC et al (1988) Interobserver agreement for the assessment of handicap in stroke patients. Stroke 19:604–607

    Article  PubMed  Google Scholar 

  17. Sulter G, Steen C (1999) Use of the Barthel Index and Modified Rankin Scale in Acute Stroke Trials. Stroke 30:1538–1541

    Article  CAS  PubMed  Google Scholar 

  18. Correia M, Silva MR, Matos I et al (2004) Prospective community-based study of stroke in Northern Portugal: incidence and case fatality in rural and urban populations. Stroke 35:2048–2053

    Article  PubMed  Google Scholar 

  19. Heuschmann PU, Di Carlo A, Bejot Y et al (2009) Incidence of stroke in Europe at the beginning of the 21st century. Stroke 40:1557–1563

    Article  PubMed  Google Scholar 

  20. Maron BJ, Doerer JJ, Haas TS et al (2009) Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980–2006. Circulation 119:1085–1092

    Article  PubMed  Google Scholar 

  21. Suárez-Mier MP, Aguilera B (2002) Causes of sudden death during sports activities in Spain. Rev española Cardiol 55:347–358

    Article  Google Scholar 

  22. Chatzikonstantinou A, Wolf ME, Hennerici MG (2012) Ischemic stroke in young adults: classification and risk factors. J Neurol 259:653–659

    Article  PubMed  Google Scholar 

  23. Overell JR, Bone I, Lees KR (2000) Interatrial septal abnormalities and stroke: a meta-analysis of case-control studies. Neurology 55:1172–1179

    Article  CAS  PubMed  Google Scholar 

  24. Stefan O, Vera N, Otto B et al (2009) Stroke in cancer patients: a risk factor analysis. J Neurooncol 94:221–226

    Article  PubMed  Google Scholar 

  25. Grisold W, Oberndorfer S, Struhal W (2009) Stroke and cancer: a review. Acta Neurol Scand 119:1–16

    Article  CAS  PubMed  Google Scholar 

  26. Fonseca AC, Ferro JM (2013) Drug abuse and stroke. Curr Neurol Neurosci Rep 13:325

    Article  PubMed  Google Scholar 

  27. Stapf C, Elkind MS, Mohr JP (2000) Carotid artery dissection. Annu Rev Med 51:329–347

    Article  CAS  PubMed  Google Scholar 

  28. Greenlund KJ, Giles WH, Keenan NL et al (2002) Physician advice, patient actions, and health-related quality of life in secondary prevention of stroke through diet and exercise * the physician’s role in helping patients to increase physical activity and improve eating habits. Stroke 33:565–571

    Article  PubMed  Google Scholar 

  29. Furie KL, Kasner SE, Adams RJ et al (2011) Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American heart association/american stroke association. Stroke 42:227–276

    Article  PubMed  Google Scholar 

  30. Sacco RL, Gan R, Boden-Albala B et al (1998) Leisure-time physical activity and ischemic stroke risk : the Northern Manhattan stroke study. Stroke 29:380–387

    Article  CAS  PubMed  Google Scholar 

  31. Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GWG, Gress DR (2003) Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology 60:1424–1428

    Article  CAS  PubMed  Google Scholar 

Download references

Conflicts of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to José M. Ferro.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 253 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alexandrino, G.M., Damásio, J., Canhão, P. et al. Stroke in sports: a case series. J Neurol 261, 1570–1574 (2014). https://doi.org/10.1007/s00415-014-7383-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-014-7383-y

Keywords

Navigation