Middle Cerebral Artery Dissection in Amusement Park: An Illustrative Case

Abstract

Neurological injuries after amusement rides are unusual, but potentially dangerous. Roller coasters have been linked with dissections of the carotid and vertebral artery resulting in strokes. But, middle cerebral artery (MCA) dissection as a cause of amusement park stroke is uncommonly described. We share a case of woman who developed headache and limb weakness after riding a tilt-a-wheel in amusement park. Magnetic resonance angiography (MRA) depicted the dissecting segment with vessel irregularity at the proximal left MCA. The patient treated with anticoagulants and later with antiplatelet agents. She had improved completely with early recanalization of the dissection in follow-up MRA. In conclusion, the riders could be informed the particular risk of cervicocephalic artery dissection (CCD) which occur under diverse contexts for amusement activities. Physicians must have a high index of suspicion for CCD when the riders note neurologic manifestations following violent motions for head and neck in amusement settings.