Vertebral Artery Dissection Caused by Swinging a Golf Club

Case Report and Literature Review

Shoko M. Yamada, MD; Yoshiaki Goto, MD; Mineko Murakami, MD; Katsumi Hoya, MD; Akira Matsuno, MD

Disclosures

Clin J Sport Med. 2014;24(2):155-157. 

In This Article

Abstract and Introduction

Abstract

Vertebral artery (VA) dissection caused by swinging a golf club is extremely rare, and the mechanism of the dissection has not been elucidated. A 39-year-old man suddenly felt sharp neck pain and dizziness when he swung a driver while playing golf and visited our clinic. Imaging studies showed acute right cerebellar infarction and complete occlusion of the right VA at the C2 (axis) level. After 1 month of 100 mg aspirin treatment, the occluded right VA was completely recanalized and the patient became totally asymptomatic. Professional golfers look at the position of the ball on the ground or tee until completion of their follow-through. However, some amateur golfers look in the direction that the ball travels at the beginning of their follow-through. It is hypothesized that this rapid disproportionate head rotation produces VA elongation and distortion, mainly at the C2 level, causing stenosis or occlusion of the artery.

Introduction

Vertebral artery (VA) dissection caused by swinging a golf club is extremely rare, and only a few cases of dissection have been reported.[1–3] Sudden head rotation in swinging a golf club is considered to cause excessive stretch and twist of the VA,[1–3] and this type of VA dissection is also caused by chiropractic neck manipulation.[4,5] Despite the cause of the injury, the mechanism of the VA dissection has not been clearly elucidated.

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