Skiing Associated Stroke: Causes, Treatment, and Outcome.

Details

Serval ID
serval:BIB_F43FD91DDED6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Skiing Associated Stroke: Causes, Treatment, and Outcome.
Journal
Journal of stroke and cerebrovascular diseases
Author(s)
Strambo D., Sirimarco G., Inácio N., Eskandari A., Michel P.
ISSN
1532-8511 (Electronic)
ISSN-L
1052-3057
Publication state
Published
Issued date
02/2019
Peer-reviewed
Oui
Volume
28
Number
2
Pages
288-294
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Previous studies have described ischemic stroke temporally related to specific triggers, but only 1 series collected patients with acute ischemic stroke (AIS) following downhill skiing and all caused by cervical artery dissections. Here we describe our series of AIS temporally associated to ski practice, focusing on the frequency, pathogenesis, clinical presentation, and prognosis.
We maintained a prospective list of Skiing Associated Strokes (SASs) from 2003 to 2017. From all AIS patients included in our stroke registry Acute Stroke Registry and Analysis of Lausanne (ASTRAL) over the same period, we identified a comparison group of non-SAS patients, matched for age and gender.
In the 12-year observation period, we identified 17 SASs (4 females, median age 51 years) and 51 matched control patients with nonski-associated strokes. Vascular risk factors, stroke features, and outcome were similar between the 2 groups. Stroke mechanism was arterial dissection in 11 of 17 SASs (65%) and in 7 of 51 control patients (14%, chi-square test: P < .05). In the other 6 cases of ski-associated stroke, etiology was cardiac embolism from atrial fibrillation in 2 patients, large vessel atherosclerosis with stenosis >50% in 1 patient, and undetermined in 3. Among the 11 patients with SAS caused by dissection, 8 reported minor falls while skiing, 1 had a major head trauma without loss of consciousness, and 2 had no traumatism (compared to preceding trauma in 29 of 147 [20%] of all other AIS caused by arterial dissection in ASTRAL, P < .01).
Arterial dissection was a significantly more frequent stroke mechanism in SAS compared to matched controls, but other mechanisms occurred as well. Minor or moderate skiing-related trauma preceded most SAS with dissections.
Keywords
Accidental Falls, Aneurysm, Dissecting/epidemiology, Aneurysm, Dissecting/therapy, Atrial Fibrillation/epidemiology, Atrial Fibrillation/therapy, Case-Control Studies, Female, Humans, Intracranial Embolism/epidemiology, Intracranial Embolism/therapy, Ischemic Attack, Transient/diagnosis, Ischemic Attack, Transient/epidemiology, Ischemic Attack, Transient/therapy, Male, Middle Aged, Prevalence, Registries, Retrospective Studies, Risk Assessment, Risk Factors, Skiing/injuries, Stroke/diagnosis, Stroke/epidemiology, Stroke/therapy, Switzerland/epidemiology, Time Factors, Treatment Outcome, Vascular System Injuries/epidemiology, Vascular System Injuries/therapy, Epidemiology, dissections, risk factors, stroke subtypes
Pubmed
Web of science
Create date
16/11/2018 10:20
Last modification date
20/08/2019 17:21
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