Three adolescent football players who had ischemic stroke associated with football practice and play are described. The literature on stroke associated with childhood sports and football in particular is reviewed, and the multiple mechanisms by which football can contribute to ischemic stroke are discussed.
LynchJHirtzDDeVeberGNelsonK.Report of the national institute of neurological disorders and stroke workshop on perinatal and childhood stroke. Pediatrics. 2002;109:116–123.
2.
FullertonHWuYSidneySJohnstonS.Risk of recurrent childhood arterial ischemic stroke in a population-based cohort: the importance of cerebrovascular imaging. Pediatrics. 2007;119:495–501.
3.
MuellerF.Fatalities from head and cervical spine injuries occurring in tackle football: 50 years' experience. Clin Sports Med. 1998;1:169–182.
4.
FelkerMZimmerJGolombM.Failure of a clot retrieval device in an adolescent stroke patient. Pediatr Neurol. 2010;43:435–438.
5.
GanesanVPrenglerMMcShaneM.Investigation of risk factors in children with arterial ischemic stroke. Ann Neurol. 2003;53:167–173.
6.
Amlie-LefondCSebireGFullertonH.Recent developments in childhood arterial ischaemic stroke. Lancet Neurol. 2008;7:425–435.
7.
WiznitzerMMasarykT.Cerbrovascular abnormalities in pediatric stroke: assessment using parenchymal and angiographic magnetic resonance imaging. Ann Neurol. 1991;29:585–589.
8.
HussonBRodeschGLasjauniasP.Magnetic resonance angiography in childhood arterial brain infarcts a comparative study with contrast angiography. Stroke. 2002;33:1280–1285.
9.
GanesanVSavvyLChongWKirkhamF.Conventional cerebral angiography in children with ischemic stroke. Pediatr Neurol. 1999;20:38–42.
SepelyakKGailloudPJordanL.Athletics, minor trauma, and pediatric arterial ischemic stroke. Eur J Pediatr. 2010;169:557–562.
16.
TekinSAykut-BingolCAktanS.Case of intracranial vertebral artery dissection in young age. Pediatr Neurol. 1997;16:67–70.
17.
RafayMArmstrongDDeVeberG.Craniocervical arterial dissection in children: clinical and radiographic presentation and outcome. J Child Neurol. 2006;21:8–16.
18.
LukenMIIIAscherlGJrCorrellJHilalS.Spontaneous dissecting aneurysms of the extracranial internal carotid artery. Clin Neurosurg. 1979;26:353–375.
19.
SchievinkWMokriBPiepgrasD.Spontaneous dissections of cervicocephalic arteries in childhood and adolescence. Neurology. 1994;44:1607–1612.
20.
PatelHSmithRGargB.Spontaneous extracranial carotid artery dissection in children. Pediatr Neurol. 1995;13:55–60.
21.
MuellerFCantuR. In: Annual survey of catastrophic football injuries 1977-2008. 2008;Chapel Hill: University of North Carolina—National Center for Catastrophic Sport Injury Research.
22.
MuellerFCantuR. In: Annual survey of catastrophic football injuries 1977-2009. 2009;Chapel Hill: University of North Carolina—National Center for Catastrophic Sport Injury Research,
23.
PodbereskyDUnsellBAntonC.Imaging of American football injuries in children. Pediatr Radiol. 2009;39:1264–1274.
24.
ProvenzaleJSarikayaB.Comparison of test performance characteristics of MRI, MR angiography, and CT angiography in the diagnosis of carotid and vertebral artery dissection: a review of the medical literature. AJR Am J Roentgenol. 2008;193:1167–1174.
25.
ChandraASulimanAAngleN.Spontaneous dissection of the carotid and vertebral arteries: the 10-year UCSD experience. Ann Vasc Surg. 2007;21:178–185.
26.
ArnoldMBousserMFahrniG.Vertebral artery dissection: presenting findings and predictors of outcome. Stroke. 2006;37:2499–2503.
27.
VertinskyASchwartzNFischbeinN.Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol. 2008;29:1753–1760.
28.
KanwarMDesaiDJoumaaMGuduguntlaV.Traumatic brachiocephalic pseudoaneurysm presenting as stroke in a seventeen-year-old. Clin Cardiol. 2009;32:E43–E45.
ShafferLRichPPohlKGanesanV.Can mild head injury cause ischaemic stroke?. Arch Dis Child. 2003;88:267–269.
32.
KieslichMFiedlerAHellerC.Minor head injury as cause and co-factor in the aetiology of stroke in childhood: a report of eight cases. J Neurol Neurosurg Psychiatry. 2002;73:13–16.
33.
TalavageTNaumanEBreedloveE.Functionally-detected cognitive impairment in high school football players without clinically-diagnosed concussion. J Neurotrauma.;[Epub ahead of print]
.
34.
DeKoskySIkonomovicMGandyS.Traumatic brain injury — football, warfare, and long-term effects. N Engl J Med. 2010;363:1293–1296.
35.
MillerG.A late hit for pro football players. Science. 2009;325:670–672.
36.
ShiiyaNKuniharaTMiyatakeT.Tau protein in the cerebrospinal fluid is a marker of brain injury after aortic surgery. Ann Thorac Surg. 2004;77:2034–2038.
37.
UchiharaTNakamuraAAraiT.Microglial tau undergoes phosphorylation-independent modification after ischemia. GLIA. 2004;45:180–187.
38.
NandoeRScheltensPEikelenboomP.Head trauma and Alzheimer’s disease. J Alzheimers Dis. 2002;4:303–308.
39.
KutnerKErlangerDTsaiJ.Lower cognitive performance of older football players possessing apolipoprotein E ϵ 4. Neurosurgery. 2000;47:651–658.
40.
ZetterbergHHietalaMJonssonM.Neurochemical aftermath of amateur boxing. Arch Neurol. 2006;63:1277–1280.
41.
BoydJCassonIDeKoskyS.Alzheimer research forum live discussion: sports concussions, demential, and apoe genotyping: what can scientists tell the public? what’s up for research?. J Alzheimers Dis. 2009;16:657–666.
SpengosKTsivgoulisGToulasP.Hyperventilation-enhanced chorea as a transient ischaemic phenomenon in a patient with moyamoya disease. Eur Neurol. 2004;51:172–175.
49.
MillichapJ.Electroencephalography hyperventilation and stroke in children with sickle cell disease. Clin Electroencephalogr Neurosci. 2006;37:190–192.
50.
DowlingMIkembaC.Intracardiac shunting and stroke in children: a systematic review. J Child Neurol. 2011;26:72–82.
SweeneyBRossorM.Medial medullary syndrome associated with patent foramen ovale in a weightlifter. Eur Neurol. 1996;36:
53.
SchwerzmannMSellerCLIppE.Relation between directly detected patent foramen ovale and ischemic brain lesions in sport divers. Ann Intern Med. 2001;134:21–24.
54.
KennyDTurnerMMartinR.When to close a patent foramen ovale. Arch Dis Child. 2008;93:255–259.
55.
MalinaRMoranoPBarronM.Overweight and obesity among youth participants in american football. J Pediatr. 2007;151:378–382.
56.
LaursonKEisenmannJ.Prevalence of overweight among high school football linemen. JAMA. 2007;267:363–364.
57.
WangMDowneyGPerkoMYesalisC.Changes in body size of elite high school football players: 1963-1989. Percept Mot Skills. 1993;76:379–383.
58.
BahrkeMYesalisC.Abuse of anabolic androgenic steroids and related substances in sport and exercise. Curr Opin Pharmacol. 2004;4:614–620.
59.
SantamarinaRBesockeARomanoL.Ischemic stroke related to anabolic abuse. Clin Neuropharmacol. 2008;31:80–85.