Subacute subdural hematoma in a 45-year-old woman with no significant past medical history after a roller coaster ride

We report the first case report of symptomatic bilateral subdural hematomas (SDH) associated with riding a centrifugal motion simulator ride. A previously healthy 55-year-old male developed new onset daily headaches 1 week after going on the ride that were due to symptomatic bilateral SDH requiring operative intervention with a full recovery. There was no history of other trauma or other systemic or intracranial abnormality to account for the development of the SDH. We review the headaches and other clinical features associated with chronic SDH. Twelve cases of roller coaster headaches due to SDH associated with riding roller coasters have been reported. The pathophysiology is reviewed, which we believe is the same mechanism that may be responsible in this case. Although it is possible that this neurovascular injury is truly rare, it is also possible that this injury is underreported as patients and physicians may not make the association or physicians have not reported additional cases. The risk of this injury likely increases with age, as the size of the subdural space increases, and may support the maxim that "roller coasters and simulators are for kids."

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“…SDH formation following roller coaster rides has been reported 12 times previously and is more than just a chance occurrence …”

Section: Expert Opinionmentioning

confidence: 64%

A Motion Simulator Ride Associated With Headache and Subdural Hematoma: First Case Report

2015

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“…Rigid body and finite element simulations provide a promising starting point to explore mechanisms for roller coaster induced subdural hematomas. 6,[8][9][10] Our rigid body simulations estimate roller coaster brain surface displacement on the order of 2.0-4.0mm, which may lead to stretching of the bridging veins between the brain and skull. 41 Although the rigid body model does not represent the bridging veins as individual substructures, we can estimate the maximum stretch within the sagittal plane: If bridging veins were oriented along the anterior-posterior direction and had an average length of 6.0 mm, they would experience stretches up to 1.67, which is close to or even beyond the critical bridging vein failure stretch of 1.50.…”

Section: Brain Deformation During Roller Coaster Rides Discussionmentioning

confidence: 93%

“…1 The accelerations experienced on roller coaster rides contribute to their thrilling nature; however, the effect of these accelerations on the brain is largely unknown. Previously, there have been several case studies reporting serious brain injuries attributed to roller coasters, [1][2][3] including seven cases of subdural hematoma, [4][5][6][7][8][9][10] two cases of subarachnoid hemorrhage, 11,12 and multiple cases of concussion. 1,13,14 These types of brain injuries have been extensively studied and are thought to be mostly caused by excessive mechanical deformations of the bridging veins causing subdural hematoma, 15 of aneurysms causing subarachnoid hemorrhage, 12,16 and of the parenchymal brain tissue itself causing concussion.…”

Section: Introductionmentioning

confidence: 99%

Pilot Findings of Brain Displacements and Deformations during Roller Coaster Rides

Kuo

et al. 2017

Journal of Neurotrauma

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With 300,000,000 riders annually, roller coasters are a popular recreational activity. Although the number of roller coaster injuries is relatively low, the precise effect of roller coaster rides on our brains remains unknown. Here we present the quantitative characterization of brain displacements and deformations during roller coaster rides. For two healthy adult male subjects, we recorded head accelerations during three representative rides, and, for comparison, during running and soccer headers. From the recordings, we simulated brain displacements and deformations using rigid body dynamics and finite element analyses. Our findings show that despite having lower linear accelerations than sports head impacts, roller coasters may lead to brain displacements and strains comparable to mild soccer headers. The peak change in angular velocity on the rides was 9.9 rad/sec, which was higher than the 5.6 rad/sec in soccer headers with ball velocities reaching 7 m/sec. Maximum brain surface displacements of 4.0 mm and maximum principal strains of 7.6% were higher than in running and similar to soccer headers, but below the reported average concussion strain. Brain strain rates during roller coaster rides were similar to those in running, and lower than those in soccer headers. Strikingly, on the same ride and at a similar position, the two subjects experienced significantly different head kinematics and brain deformation. These results indicate that head motion and brain deformation during roller coaster rides are highly sensitive to individual subjects. Although our study suggests that roller coaster rides do not present an immediate risk of acute brain injury, their long-term effects require further longitudinal study.

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ジェットコースター乗車後に生じた硬膜下血腫の1例(Subdural hematoma after riding a roller coaster: a case report)

靖一

真一

雄樹

et al. 2015

Japanese Journal of Japanese Association for Acute Medicine

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要旨症例は2年前に右前頭葉底部の脳挫傷で当院入院加療した既往のある63歳の女性。遊園地でジェットコースターに5回乗車した。乗車後より頭重感があったが様子をみていた。翌日に頭痛が増悪したため近医を受診し，頭部CTで右急性硬膜下血腫を認め，同院に入院した。経過観察にて硬膜下血腫は減少し，症状も改善したため，入院から4日後に退院となった。しかし，近医退院から6日後に意識レベルJCS 2と見当識障害が出現し，頭部CTで右硬膜下血腫の増大を認めたため，当科入院となった。入院後直ちに穿頭血腫除去術を行い，術5日目に神経学的脱落症状なく，独歩自宅退院した。ジェットコースターに乗車したことが原因として考えられる硬膜下血腫の症例報告は過去に7例ある。本症例において硬膜下腔へ出血性変化が生じた原因としては，次の2つの可能性があると考えている。1つは，ジェットコースター乗車による頭部への急加減速，急激な回転加速度負荷がきっかけとなって脳表と硬膜との間にずれが生じ，以前の脳挫傷による脳表と硬膜との癒着がはがれ血管破綻が生じた可能性である。もう1つは，頻回のジェットコースター乗車により架橋静脈が破綻して急性硬膜下血腫を来し，慢性硬膜下血腫へ移行した可能性である。本症例のように，ジェットコースター乗車を契機に頭蓋内病変を生じる場合があり，診断・治療上も注意を要する。

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Subacute subdural hematoma in a 45-year-old woman with no significant past medical history after a roller coaster ride

Cited by 6 publications

References 11 publications

A Motion Simulator Ride Associated With Headache and Subdural Hematoma: First Case Report

A Motion Simulator Ride Associated With Headache and Subdural Hematoma: First Case Report

Pilot Findings of Brain Displacements and Deformations during Roller Coaster Rides

ジェットコースター乗車後に生じた硬膜下血腫の1例(Subdural hematoma after riding a roller coaster: a case report)

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