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From the Department of Neurology (Drs. Evers and Ringelstein), University of Münster; and the Department of Music Physiology and Music Medicine (Dr. Altenmüller), Hannover College of Music and Theater, Germany.
Address correspondence and reprint requests to Dr. Stefan Evers, Department of Neurology, University of Münster, Albert-Schweitzer-Str. 33, 48129 Münster, Germany; e-mail: everss{at}uni-muenster.de
Two cases of ischemic stroke due to carotid artery dissection occurring during wind instrument playing, probably caused by increased intrathoracic and subsequent intrapharyngeal pressure, are presented. A review of the literature revealed three similar patients with other types of cerebrovascular events, such as paradoxical cerebral embolism due to a patent foramen ovale and spinal epidural hematoma during trumpet playing.
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