Although uncommon, an entirely different group of factors plays a role when an athlete suffers a stroke.
Head and neck trauma are often factors in stroke during athletic competitions. Direct head trauma can result in leakage from blood vessels, depriving large regions of the brain of necessary nutrients.
Violent forward and backward movement of the head can result in tearing the inner lining of vital arteries responsible for directing blood to the brain. This condition, known as arterial dissection, can form a clot within the affected blood vessel or become a source of small clots. These smaller clots often move toward the brain as emboli and block other arteries.
Treatment for arterial dissection involves the use of blood thinning medications and avoiding violent collision sports.
Another common risk factor for stroke in athletes is the existence of a patent foramen ovale (PFO). A PFO is a hole between the upper chambers of the heart, the right and left atria. The foramen ovale forms in the fourth week of embryonic development and should close in the first three months after birth. When it does not close, it is considered patent or open.
This abnormal channel allows direct passage of blood clots to the brain. These clots often originate in the legs and may result from immobilized lower extremities.
PFOs can be treated with equal success by surgical closure or blood thinning medications. Athletes appear to do better with surgical closure and usually make a full recovery to return to sports.
While considered rare, strokes do occur in athletes and treatment requires a different approach.