I asked Jason Goldsmith, a pharmacology Ph.D. who is finishing his MD and also runs a martial arts school. "Any strong choke (that can generate a tap), has roughly the same risk whether it makes someone go unconscious or not," he says. "The big risk is causing a stroke, from a cholesterol plaque being dislodged from your carotid artery and wedging itself in your brain." He refers to this as a caratoid embolism leading to an ischemic stroke. "This is a "normal" mechanism of stroke," he continues. "It occurs outside of grappling. With chokes there is some very small increase in risk of this occurring...as for going unconscious there is no added risk from that, unless someone holds the choke for 30+ seconds after they pass out. Then you worry about brain damage."Unfortunately, this unlikely scenario has claimed the life of a jiu jitsu practitioner in Brazil. During jiu jitsu practice, Napoleon Jose Alves was choked with a rear naked choke and did not feel well subsequently. He went to the hospital, where he was sent away for not having a real emergency and was asked to come back another day. When he later returned to the hospital, it was found that he had suffered a stroke and he unfortunately died from complications of that stroke. Jiu Jitsu Times has an article about this sad course of events: 32 Years Old Jiu-Jitsu Practitioner In Brazil Dies 2 Days After A Choke
I can't help but wonder if the outcome would have been different if Alves' complaints were taken more seriously and if he had received prompt medical attention. The American Stroke Association has a saying: "Time lost is brain lost." While our risk is small, jiu jitsu practitioners should be aware of the signs of stroke and should seek prompt, medical treatment if they recognize any of these in themselves or in their training partners.
First, look for the following:
Beyond F.A.S.T., The American Stroke Association lists the following signs of a stroke:
- "Sudden numbness or weakness of the leg, arm or face
- Sudden confusion or trouble understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause"
Napoleon Jose Alves did the right thing by seeking immediate medical attention, but unfortunately he did not receive the prompt care that he sought. Death due to stroke is very rare in the jiu jitsu community, but it is important that any signs of stroke be treated as a medical emergency. My thoughts are with Alves and his family during this time.
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