Intracerebral Haemorrhage Following Roller Coaster Exposure Presenting with Gerstmann Syndrome: A Case Report

Background: Intracerebral haemorrhage (ICH) is a life-threatening subtype of stroke most associated with chronic hypertension and cerebral amyloid angiopathy. However, acute haemorrhagic events may rarely be triggered by intense physical exertion or emotional stress, posing diagnostic challenges in patients without traditional risk factors. Case Report: A 65-year-old woman presented with sudden-onset severe headache following a roller coaster ride, accompanied by acute right-sided weakness and higher cortical dysfunction, including alexia, agraphia, acalculia, and finger agnosia. Brain magnetic resonance imaging revealed an acute lobar intracerebral haemorrhage in the left temporoparietal region without evidence of vascular malformation or coagulopathy. The clinical and radiological findings were consistent with Gerstmann syndrome secondary to intracerebral haemorrhage. The patient was managed conservatively and showed improvement in motor and language function, although cognitive deficits persisted at discharge. Discussion: In the absence of conventional risk factors, this case suggests a possible association between intracerebral haemorrhage and acute physiological stress induced by high-acceleration rides. Proposed mechanisms include transient surges in blood pressure, sympathetic overactivity, and vascular vulnerability. This case also highlights the importance of recognizing secondary headache with focal neurological deficits as a red flag for intracranial pathology. Conclusion : Intracerebral haemorrhage should be considered in patients presenting with acute headache and neurological deficits following intense physical or emotional stimuli, even in the absence of known risk factors. Early recognition and prompt neuroimaging are essential for accurate diagnosis and management.