Wednesday, July 16, 2014 Yanni Anyone? Headbanging Linked to Brain Injury, Whiplash It turns out that so-called heavy metal "headbangers" do just that, and violently enough to occasionally result in brain injury, whiplash, and other problems. The July 5 issue of The Lancet includes a letter to the editor that describes treatment of a subdural hematoma in a 50-year-old man who presented with a worsening headache that had been going on for 2 weeks. He had an unremarkable medical history and denied substance abuse. What he did mention was that just before his headache began, he attended a concert by Motorhead, a seminal speed metal band. And like many others in the audience, he spent much of the concert headbanging, which letter author Ariyan Pirayesh Islamian, MD, describes as "a contemporary dance form consisting of abrupt flexion-extension movements of the head to the rhythm of rock music, most commonly seen in the heavy metal genre." According to the author, the case he encountered wasn't the first instance of brain injury brought on by headbanging: Islamian's literature search uncovered at least 3 other instances, 1 of which resulted in death. In the case of the patient described in the letter, Islamian reckons that the rapid acceleration and deceleration forces of headbanging "led to rupturing of bridging veins causing hemorrhage into the subdural space." The hematoma was removed and the patient has fully recovered. "Although generally considered harmless, health complications attributed to [headbanging] include carotid artery dissection, mediastinal emphysema, whiplash injury, and odontoid fracture," Islamian writes. "This case serves as evidence in support of Motorhead's reputation as one of the most hardcore rock 'n roll acts on earth, if nothing else because of their contagious speed drive and the hazardous potential for headbanging fans to suffer brain injury." Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.