Traumatic carotid and vertebral artery dissection in a professional jockey: a cautionary tale.
Abstract: Jockeys accept bony fractures and soft tissue injuries as occupational hazards. An average National Hunt jockey falls once in ten races with an injury rate of 4.25%. Head injury is a common cause of morbidity and the benefit of helmets is well recognized. Neck injuries are also common and usually musculoskeletal. Although rare, trauma to the neck arteries may go unnoticed yet have catastrophic consequences. Internal tears can allow arterial blood to dissect the layers of the arterial wall and obstruct the lumen. Severe obstruction may lead to cerebral ischaemia and infarction. An appreciation of the early clinical signs caused by this process may allow effective intervention. We report a case which illustrates these points.
Publication Date: 1995-06-01 PubMed ID: 7551762PubMed Central: PMC1332298DOI: 10.1136/bjsm.29.2.143Google Scholar: Lookup
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Summary
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The research article discusses the case of a professional jockey who experienced severe damage to his neck arteries as a result of a racing incident, highlighting the need for early detection of such injuries to prevent potentially devastating health impacts.
Context of the Research
- The research was motivated by the occupational hazards jockeys face, particularly fractures and soft tissue injuries. Jockeys often sustain injuries due to falling from horses, with an average National Hunt jockey falling in one out of every ten races and a general injury rate of 4.25%.
- Head injuries are common and often severe, although helmets can significantly reduce the risk. Neck injuries are also frequent occurrences, but they are typically musculoskeletal in nature.
Uncommon but Significant Neck Injuries
- The study highlights an uncommon but potentially dangerous type of neck injury: trauma to the neck arteries. Although rare, these injuries can be particularly insidious because they may not be immediately apparent.
- Internal tears in the neck arteries can allow arterial blood to break apart the layers of the arterial wall and obstruct the artery. This obstruction can be severe, potentially leading to cerebral ischemia (insufficient blood flow to the brain) and infarction (tissue death due to lack of oxygen). These conditions can have catastrophic consequences if not promptly treated.
Importance of early detection and intervention
- A key takeaway from the study is the importance of recognizing the early clinical signs of potentially severe neck injuries. Early detection and appropriate intervention can prevent major health consequences such as cerebral ischemia and infarction.
- The researchers illustrate this point through a case study of a professional jockey who suffered from a traumatic carotid and vertebral artery dissection (tears in the arteries of the neck).
Cite This Article
APA
Fletcher J, Davies PT, Lewis T, Campbell MJ.
(1995).
Traumatic carotid and vertebral artery dissection in a professional jockey: a cautionary tale.
Br J Sports Med, 29(2), 143-144.
https://doi.org/10.1136/bjsm.29.2.143 Publication
Researcher Affiliations
- Department of Neurology and Neuroradiology, Frenchay Hospital, Bristol, UK.
MeSH Terms
- Adult
- Aortic Dissection / etiology
- Animals
- Arterial Occlusive Diseases / etiology
- Athletic Injuries / etiology
- Brain Ischemia / etiology
- Carotid Artery Diseases / etiology
- Carotid Artery Injuries
- Cerebral Infarction / etiology
- Horner Syndrome / etiology
- Horses
- Humans
- Male
- Vertebral Artery / injuries
References
This article includes 1 references
- Hart RG, Easton JD. Dissections.. Stroke 1985 Nov-Dec;16(6):925-7.
Citations
This article has been cited 9 times.- Maiese A, Frati P, Manetti AC, De Matteis A, Di Paolo M, La Russa R, Turillazzi E, Frati A, Fineschi V. Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation. Curr Neuropharmacol 2022 Aug 3;20(9):1752-1773.
- Schlemm L, Nolte CH, Engelter ST, Endres M, Ebinger M. Cervical artery dissection after sports - An analytical evaluation of 190 published cases. Eur Stroke J 2017 Dec;2(4):335-345.
- Saw AE, McIntosh AS, Kountouris A, Newman P, Gaida JE. Vertebral Artery Dissection in Sport: A Systematic Review. Sports Med 2019 Apr;49(4):553-564.
- Wachal K, Koczewski P, Gabriel M, Kociemba W. Isolated internal carotid artery dissection in a long-distance runner. Wideochir Inne Tech Maloinwazyjne 2016;11(4):304-308.
- Mas Rodriguez MF, Berrios RA, Ramos E. Spontaneous Bilateral Vertebral Artery Dissection During a Basketball Game: A Case Report. Sports Health 2016 Jan-Feb;8(1):53-6.
- Kalantzis G, Georgalas I, Chang BY, Ong C, El-Hindy N. An Unusual Case of Traumatic Internal Carotid Artery Dissection during Snowboarding. J Sports Sci Med 2014 May;13(2):451-3.
- Brand S, Teebken OE, Bolzen P, Hildebrand F, Wilhelmi M, Krettek C, Probst C. [Traumatic dissection of carotid arteries caused by high energy motorcycle accident]. Unfallchirurg 2012 Oct;115(10):930-5.
- Turner M, McCrory P, Halley W. Injuries in professional horse racing in Great Britain and the Republic of Ireland during 1992-2000. Br J Sports Med 2002 Dec;36(6):403-9.
- Biffl WL, Moore EE, Elliott JP, Ray C, Offner PJ, Franciose RJ, Brega KE, Burch JM. The devastating potential of blunt vertebral arterial injuries. Ann Surg 2000 May;231(5):672-81.
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