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By Bruce R. Anderson, Jr. and Matthew W. Sowell

Profes­sional football teams cut players all the time. However, Russell Allen, a valuable player for the Jacksonville Jaguars, faced something out of the ordinary this off-season. On April 23, 2014, he was cut from the team because he had suffered a stroke.

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(Photo: Stephen Morton, AP)

Allen had been a linebacker with the Jaguars for five seasons. On December 15, 2013, during a game against the Buffalo Bills, Allen collided head on with another player while trying to make a tackle. At some point during the collision, Allen suffered a tear in his carotid artery. That tear caused Allen to have a stroke. Allen played the rest of the drive before he started to have symptoms. In spite of double-vision, Allen finished the game. He later experi­enced severe headaches and sensi­tivity to light – all of these being warning signs of stroke.

While it is rare to see this kind of a stroke in this setting, as lawyers who frequently represent victims of stroke, we have seen it in similar incidents — usually car wrecks or cases where someone’s neck was twisted abruptly. Carotid artery strokes have been reported in a number of situa­tions: hyper­ex­tension of the neck in automobile and motor­cycle colli­sions; direct trauma to the neck by seat belts; abnormal positioning of the head during lengthy surgery; chiro­practic manip­u­la­tions; martial arts maneuvers; and, roller coaster rides. There have even been reported cases of such a stroke after prolonged phone calls, heavy vomiting, violent coughing, and vigorous nose blowing.

The carotid arteries, along with the vertebral arteries, are the main arteries through which blood travels from the heart to the brain. Carotid artery injuries can happen sponta­neously, as a result of diseases involving the artery, or from twisting that trauma­tizes the artery. The carotid runs off of the ascending aorta and travels directly to the brain. When a tear develops in the wall of the carotid artery, clots will begin to form at the site of the tear. Pieces of those clots can and do break off and travel in the blood stream to the arteries of the brain. Such a clot will continue to travel deeper in the brain until it reaches a point where the diameter of the clot exceeds the diameter of the artery. This blockage clogs the artery and causes a stroke in the brain tissue fed by that artery.

As with all strokes, time is brain. A stroke caused by a tear inside the carotid artery can be prevented, if identified and treated early. Once a tear in the carotid is found, the antico­ag­ulant heparin is given to prevent the formation of new clots and stop the growth of existing clots. With the timely admin­is­tration of heparin, the chances of having another clot travel to the brain are extremely reduced. For the most severe carotid artery tears, the damaged artery can be repaired surgi­cally or by the placing stents in the vessel.

Although Russell Allen made a relatively good recovery, he can no longer play a sport that brought him much joy and paid well. Many other victims of such a stroke do not fare as well. We have worked with clients who have unnec­es­sarily lost the use of one side of their body, the ability to commu­nicate effec­tively, or the ability to care for themselves – all because the warning signs of stroke were not rapidly evaluated and treated.

The takeaway from Mr. Allen’s stroke is that anyone experi­encing the warning signs of stroke should have those signs evaluated at a Stroke Center immedi­ately.

Warning Signs of a Stroke

For more on Russell Allen and stroke click here.

Arnold M. Carotid artery dissection and sports. Kardio­vaskuläre Medizin 2009;12(7–8):209–213

Biffl WL, et al. The unrec­og­nized epidemic of blunt carotid arterial injuries: early diagnosis improves neuro­logical outcome. Ann Surg. Oct 1998; 228(4): 462–470. 1