Stroke and Athletes: A Scoping Review

Abstract

Stroke (i.e., cerebrovascular accident) affects one in 10,000 people between the ages of 14 and 45; however, very little is known about the frequency and type of stroke that occurs in athletes. The risk of injury to the neurovascular structures may depend on the type of sport involvement, although, sport-specific incidence rates are not known. Therefore, the goal of our scoping review was to provide some guidance to better inform the development of a context-fit stroke model by summarizing studies on a broad research topic related to stroke or cerebrovascular accident in sport based on a strict athlete definition. We used the guidance of Arksey and O’Malley’s five-stage-process for a scoping review. Databases included MEDLINE(R) Epub Ahead of Print, In-Process & Other Non- Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R), and Embase (OVID databases); CINAHL Plus with Full Text, SportDiscus with Full Text (Ebsco databases); and Scopus. Publication dates were from 1979–2020 across nine different countries resulting in 39 individual cases of stroke with an athlete age range of 14–56 years (95% male). The major inciting event(s) prior to stroke onset were headaches (38.4%), head trauma (30.7%), and neck injury and/or vertebral artery dissection (20.5%). Several sporting activities were represented with American football as the most prevalent (30.7%). In summary, we found that sports with an aspect of impact, collision, or microtrauma can lead to subsequent stroke. These sport-related traumatic events were often difficult to diagnose because of the longer interval before ischemia occurred. Therefore, health care providers should be particularly attuned to the possibility of stroke when evaluating athletes presenting with or without neurological deficit.

Traumatic dissection of the anterior cerebral artery secondary to a rugby related impact: A case report with emphasis on the usefulness of T1-VISTA

“…[15] Most types of intracranial hemorrhage such as subdural hematoma, epidural hematoma, and subarachnoid hemorrhage are commonly considered in the differential diagnosis of SRHIs; [22] in contrast, cerebrovascular injuries (CVIs) are rarely contemplated. [4,16] Furthermore, most of the few reports on sport-related CVIs refer to cervical vascular injuries and reports of intracranial vascular injuries are scarce. [1,22] We present a rugby player who had a right frontal lobe infarction due to traumatic dissection of the anterior cerebral artery (ACA), which resulted in transient left lower extremity paralysis after a hard blow to the forehead.…”

“…[ 15 ] Most types of intracranial hemorrhage such as subdural hematoma, epidural hematoma, and subarachnoid hemorrhage are commonly considered in the differential diagnosis of SRHIs;[ 22 ] in contrast, cerebrovascular injuries (CVIs) are rarely contemplated. [ 4 , 16 ] Furthermore, most of the few reports on sport-related CVIs refer to cervical vascular injuries and reports of intracranial vascular injuries are scarce. [ 1 , 22 ]…”

Integrated Approach to Highlighting the Molecular Bases of a Deep Vein Thrombosis Event in an Elite Basketball Athlete

“…Although physical exercise and an appropriate diet represent a correct lifestyle capable of preventing the appearance of some pathologies, such as heart disease [1], stroke [2], diabetes [3], and breast and colon cancer [4], the practice of physical activity can have a double effect. Indeed, mild to moderate aerobic exercise can be beneficial to health and can also increase life expectancy [5].…”