Roller coaster headache and subdural hematoma

Abstract

Riding giant roller coasters may increase the risk of subdural hematomas. There have been three recent case reports on the topic. 1-3 A 26-year-old man developed bilateral subdural hematomas after riding a double-loop, corkscrew-type roller coaster. 1 A 64-year-old hypertensive man had headaches after his first rollercoaster ride and developed a left-sided chronic subdural hematoma after 11 more rides. These two cases had successful surgical evacuation. 1-2 A fatal outcome was reported in a 73-year-old man being treated with warfarin. 3 This patient developed a left-sided subdural hematoma and a parenchymal temporal hematoma 5 days after a roller-coaster ride. Despite surgery, he died 13 days later.We report the new case of a previously healthy woman who developed headaches and bilateral chronic subdural hematomas after a series of roller-coaster rides.Case report. A 24-year-old Japanese woman visited our hospital with a headache of 4 days duration. She was otherwise in good health and did not previously have headaches. She drank alcohol only on social occasions and did not smoke. She visited amusement parks three or four times per year. The headache developed as the woman was on her way home from Fujikyu Highland Park, Yamanashi Pref., Japan, where she had ridden three different roller coasters, each twice. One of these, the Fujiyama, is the world's highest roller coaster at 259 feet. It has a drop of 230 feet at an angle of 65°and has the world's fastest speed of 81 mph (http://www.rollercoaster.com/statistics accessed March 1, 1999). There was no direct trauma to her head or loss of consciousness during the rides. In the first interview, she did not mention rollercoaster rides but stressed how hard her visual display terminal (VDT) work had been over the past 2 months.The woman's headache was constant, mainly suboccipital, worse in the evening, and partially relieved by rest. Upon examination, her temperature was 36.8°C, blood pressure 84/50 mm Hg, and heart rate 72 beats per minute. She was alert, cooperative, and well oriented. There was no evidence of head trauma, and her tympanic membranes were normal. Her neck was supple, but her shoulders were stiff and tender. Neurologic examination results were normal. Her pupils were equal and reactive to light, and there was no papilledema or retinal hemorrhages. Routine laboratory tests for blood and urine all were normal. Tension-type headache was initially diagnosed, and muscle relaxants were prescribed for 4 weeks with some benefit; the headaches fluctuated but were unrelieved.Two months later, MRI of the head ruled out an organic problem and showed bilateral subdural hematomas with neomembranes (figure). At this time, coagulation tests gave a platelet count of 189,000/mm 3 , a bleeding time of 4 minutes, a whole-blood clotting time of 6 minutes, a prothrombin time of 12.2 sec, an activated partial thromboplastin time of 40 seconds, and an AT-III of 111%. Fibrinogen and fibrin degradation product (FDP) serum levels were normal. We evacuated both hematomas, which ...

Emergency Department Visits from a Local Amusement Park

“…There were no mortalities reported. [6], crush injury to finger [4], bit by animal [3], blunt injury to eye [3], embedded foreign body into skin [3], thermal burn [2], fall out of golf cart [1], hit by thrown bottle [1], insect flew into ear canal [1], injured hand hitting punching bag [1], crush injury to hand [1], chemical exposure to eye [1], pedestrian struck by car in parking lot [1], crush injury to foot [1], and near drowning [1]. Of those hospitalized to the inpatient floor, 20% were secondary to heat-related illness.…”

“…There have been several published case reports linking roller coaster rides with neurologic complications, including subdural hematomas, internal carotid artery and vertebral artery dissections, subarachnoid and intraparenchymal hemorrhages, carotid artery thrombosis with stroke, and spinal injuries (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Roller coaster and other amusement park rides also have been associated with pneumothorax, dislocated intraocular lens, partial hepatic amputation, corneal foreign body, and peritoneal dialysis catheter displacement (16 -20).…”

Head Motions While Riding Roller Coasters

“…Rather, this misperception appears to stem from a fundamental misunderstanding of the role of G forces in TBI linked with a handful of case reports of patients suffering brain bleeding around the time of riding a roller coaster 14, 15, 17, 18, 63–70. The human body can withstand very large G-forces when they occur over very short time periods.…”

Applications and limitations of Forensic Biomechanics: A Bayesian perspective

“…50,51 Indeed, anticoagulated patients have been found to have sustained subdural hemorrhages following exposure to the relatively mild and typically noninjurious head accelerations that occur on roller coasters. 52 This leads to two difficulties with estimating a pre-test probability of injury for the forensic biomechanical analysis; first, the rationale employed by Hayes et al in arriving at a HIC of 1000 (that a 50% risk of an AIS 3+ injury was the threshold for injury the decedent) cannot be extrapolated to an anticoagulated individual. As there is no lower boundary for the force required to cause the injury, then all that is left is the meaningless upper boundary of a HIC of 1000, below which a skull fracture would not be expected.…”