Teaching Neuro Images : Head banging without head trauma

Abstract

A 24-year-old hard rock enthusiast presented with a left-sided, intense headache. He denied head trauma, but reported "head banging" intensively during a rock concert 2 days before admission. There were no neurologic deficits. CT and MRI revealed a left-sided subdural hemorrhage (SDH) and an arachnoid cyst at the left temporal pole (figure). The patient underwent surgical evacuation of the SDH with excellent outcome. Head banging with its brisk forward and backward acceleration and deceleration likely caused the SDH in our patient. Arachnoid cysts as a predisposing factor for SDH have been reported previously.

Traumatic Brain Injury After Music-Associated Head Banging: A Scoping Review

“…All 13 studies were case studies ( table 1 ). 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 The mean ± SD age was 22.8±10.5 years, with a range of 11-50 years. Sex distribution leaned heavily male (77%).…”

Recurrent subdural hematoma secondary to headbanging: A case report

“…In six previous cases of subdural hematoma due to headbanging, two patients had an arachnoid cyst in the middle fossa, ipsilateral to the hematoma, suggesting that headbanging may cause subdural hematoma in patients with predisposing factors for subdural hematoma like an arachnoid cyst. [ 1 6 9 11 13 15 ] Although other four patients were not reported to have such predisposing factors, we think that constitutional course and little play of bridging veins (BV) in subdural space might contribute to excessive strains and rupture of itself after shifting of the brain and cerebrospinal fluid during headbanging in other patients. When the human cadaver heads were subjected to impact, the relative displacement between the brain and skull were reported to be on the order of ± 5 mm.…”

“…In medical journals, carotid dissection, subdural hemorrhage, basilar artery thrombosis, vertebral artery aneurysm, and mediastinal emphysema have been reported as severe health complications. [ 1 3 4 6 8 9 10 11 12 13 14 15 ]…”

“…This abrupt flexion-extension movement of the head to rock music has been recently reported to cause subdural hematoma in “The Lancet,” however, the number of such reports is very limited as compared with the number of “headbangers” in the world. [ 1 6 9 11 13 15 ] Here, we report a case of a 24-year-old woman with subdural hematoma after headbanging at punk rock concerts with no recent history of head trauma. Since, she had an acute subdural hematoma on the same side after an accidental fall from a baby buggy when she was about 1-year old, present is recurrent subdural hematoma due to headbanging.…”

Arachnoid Cyst with a Non-traumatic Acute Subdural Hematoma in an Eleven-year-old Patient

“…We found that patients with symptomatic arachnoid cysts can safely undergo a key-hole craniotomy and drainage procedure with reported success. 6,8…”