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Minor trauma causing stroke in a young athlete.

Vineet Gupta1, Naveen Dhawan2, Jaya Bahl3

  • 1Department of Medicine, University of California San Diego (UCSD), San Diego, CA 92103, USA.

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Sudden dizziness and clumsiness after sports may signal vertebral artery dissection (VAD). Prompt diagnosis and treatment, including anticoagulation, are crucial for recovery in young athletes. This case highlights VAD in sports-related neck injuries.

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Sports Medicine

Background:

  • Vertebral artery dissection (VAD) is a critical condition that can lead to stroke.
  • Sports activities involving neck hyperextension or hyperrotation pose a risk for VAD.
  • VAD often presents with subtle symptoms and a history of minor trauma, complicating diagnosis.

Purpose of the Study:

  • To report a case of VAD in a young athlete following a wrestling match.
  • To emphasize the importance of considering VAD in the differential diagnosis of sports-related neurological symptoms.
  • To discuss current treatment modalities for VAD.

Main Methods:

  • A 17-year-old male presented with acute neurological symptoms including dizziness and ataxia.
  • Diagnostic imaging, including CT Angiogram (CTA) and MRI, confirmed left vertebral artery dissection (VAD).
  • The patient was managed with anticoagulation therapy.

Main Results:

  • The patient was diagnosed with left vertebral artery dissection (VAD) after experiencing sudden onset neurological symptoms.
  • Imaging confirmed the VAD, likely related to trauma sustained during a wrestling match.
  • The patient responded well to anticoagulation treatment and was discharged on bridging therapy.

Conclusions:

  • Vertebral artery dissection (VAD) should be considered in young athletes presenting with neurological symptoms after neck trauma, even if minor.
  • A low threshold for suspicion is necessary for timely diagnosis and management of VAD.
  • Both antiplatelet therapy and anticoagulation are recognized treatment options for VAD, depending on clinical context.