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Roller coasters and cervical artery dissection

Article  in  The Medical journal of Australia · October 2015

DOI: 10.5694/mja15.00715

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 Snapshot

Roller coasters
and cervical artery
dissection

A
42-year-old woman with no vascular risk factors was
admitted with neck pain and right Horner syndrome after
riding a roller coaster. Magnetic resonance imaging (MRI)
of her neck showed a characteristic crescent-shaped intramural
haematoma in the right internal carotid artery1 (Figure, A),
confirmed by magnetic resonance angiogram (MRA) (Figure, B).
T1-fat-suppressed MRI and arterial wall imaging are currently the
most sensitive techniques for diagnosis of dissection. Riding roller
coasters has been associated with shearing neck injury leading to
cervical artery dissection.2 Our patient was treated with warfarin
Monica S Badve
for 6 months, leading to the intramural haematoma resolving and
MB BS, FRACP1,2 the Horner syndrome greatly improving. 
Sandeep Bhuta
MB BS, FRANZCR1,2 © 2015 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.

1 Gold Coast University References are available online at www.mja.com.au.

Hospital, Gold Coast, QLD.
2 Griffith University, Gold
Coast, QLD.

monicabadve@gmail.
com A. T1-fat-suppressed MRI of neck. Arrow: intramural
haematoma in right internal carotid artery. B. MRA of
neck. Arrow: narrowing of C1 segment of right internal
doi: 10.5694/mja15.00715 carotid artery.

MJA 203 (8) · 19 October 2015

339
 1 Ozdoba C, Sturzenegger M, Schroth G. Internal carotid artery
dissection: MR imaging features and clinical-radiologic
correlation. Radiology 1996; 199: 191-198.
2 Biousse V, Chabriat H, Amarenco P, Bousser MG. Roller-coaster-
induced vertebral artery dissection. Lancet 1995; 346: 767.

339.e1 MJA 203 (8) · 19 October 2015

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