Health :Beware of beauty parlour stroke syndrome Avoid jerks, abrupt neck movements

Over the past week, the term “beauty parlour stroke syndrome” has been heard everywhere, especially on social media. Researchers have found that similar cases are common among men walking into salons for a neck massage. In this week’s health talk, Tanisha Saxena brings a detailed report on the syndrome.

Last week, a 50-year-old woman from Hyderabad city suffered a stroke while getting her hair washed before a haircut in a beauty parlour. The woman further developed symptoms at the parlour, such as nausea, dizziness, and vomiting. A doctor’s diagnosis followed by an MRI revealed a stroke.

According to the study conducted by the Departments of Neurology and Neuroradiology, Stroke Unit, University of Erlangen-Nuremberg, Erlangen, Germany, Beauty Parlor Stroke Syndrome, a term proposed by Weintraub in 1993 Pathophysiologically, acute arterial dissection is considered to be a major cause. In these cases, patients often report pain in the neck, and a predisposing intimal-medial weakness has been assumed. Other predisposing vascular factors discussed for this stroke entity are atherosclerosis, impaired collateral blood flow, and the presence of congenital vascular hypoplasia. However, the speed applied force, and duration of hair washing definitely contribute.

Moreover, researchers have found that similar cases are common among men walking into salons for a neck massage. If we boil down the medical jargon, then incidents like these happen when important blood vessels called vertebral arteries, which carry blood to the brain, get manipulated. They are very delicate and susceptible to injury.

The Pioneer connected with a few city-based neurologists; let’s hear them out on “beauty parlour stroke syndrome”. Dr Praveen Kumar Yada, a Senior Consultant Neurologist at KIMS, explained, “As I visit our neighbourhood salon and see the patrons asking for the neck massage and twist, I get the jitters as it reminds me of the summer of 2015 when a visiting Indian doctor from the USA got a massage at the neighbourhood parlour and after two days he developed stroke. He reached the hospital in three hours and received the clot-busting drug.

Yes, an innocuous massage can cause a life-threatening event. It occurs because the blood vessels supplying the brain are housed in a series of neck bones, and a sudden jerk can cause a catastrophic stroke.The tragic event in which an Australian cricketer was hit led to vertebral artery dissection, leading to an untimely death.”

He further cautioned us, adding, “We must note — avoid jerks or abrupt neck movements. Severe giddiness may suggest a stroke, so don’t ignore it.”

We also looked at a journal published by The Lancet, which stated that salon shampooing is generally safe but may be hazardous for certain people. An individual’s threshold for ischaemic symptoms depends on several factors, including speed and duration of movements, intactness of collateral blood flow, the extent of atherosclerosis, and the presence of congenital hypoplasia or intimal arterial defects. Early arterial dissection should be suspected if an anterior headache develops after the shampoo, suggesting internal carotid artery dissection rather than a vertebral artery dissection (which usually produces posterior head-and-neck discomfort). Acute neck pain and dizziness are common symptoms after shampooing, suggesting vertebral-basilar ischaemia or vertebral artery dissection.

Doctor Manoj Vasireddy from Amor Hospital, Kukatpally, pointed out two significant reasons. He said, “Firstly, neck manipulation by untrained professionals is a common cause of stroke. Secondly, it is more often seen in men, who get neck or head massages.”

He goes on to explain a few
symptoms of stroke, which are:
[1] Sudden onset of imbalance
[2] Slurred speech
[3] Deviation of the mouth to one side
[4] Weakness of a hand or leg

Furthermore, doctor Vasireddy said, “Avoid neck massage or manipulation by unqualified people (other than a qualified physiotherapist/chiropractor/or medical doctor). Lastly, seek emergent medical help in case anyone experiences any symptoms of paralysis.”

While we are discussing this syndrome in great detail, it is equally important to note the fact that Dr Charan Teja Koganti, Associate Professor, VRKMC, Hyderabad, and consultant neuropsychiatrist, highlighted. He talked about the rarity of the syndrome. He said, “The last incident I remember happening was in Japan. This happens due to prolonged hyperextension of the neck. A blood clot that is formed during this process can dislodge and cause a stroke later on. Also, the time spent on the procedure can be reduced if it is more efficient. However, it is very rare to happen.”

We are indeed living a lifestyle that is extremely exhausting. And while health emergencies don’t discriminate, we do have a responsibility towards ourselves. Taking note of the incident and interacting with it is Likhita Yalamanchili, a doctor by profession, model, and influencer at heart. She amplified, “Stroke is an emergency condition for us. Acting at the earliest possible time is the only way to minimise brain damage.

As every minute passes, stroke affects the brain even more. I believe educating or spreading awareness of the symptoms of stroke is key. Time is most important in a medical emergency, and recognising the symptoms is the first thing in the individual’s hands. Also, before stroke sets in, the affected person might notice a transient ischemic attack. This is a brief episode wherein the person experiences symptoms of stroke that last for less than an hour. Being watchful is yet again crucial so that immediate assistance can be provided by the doctors.”

This incident definitely serves as a wake-up call to salon owners in considering their duty of care in relation to their clients, fully understand the related health risks that exist at the salon backwash, and doing something about it.

Highlighting some basic measures that the salon should work on to avoid such incidents, we have Dr Aarushi Mittal, who is a dermatologist and deals with a lot of hair dye and salon-related mishaps every day, she shared a list of a few simple ways to prevent this syndrome:

• Use a head bed (head-neck cushion) because they are made from five-star high-grade silicone rubber, which is hygienic, soft, ergonomic, and durable for literally thousands of washes.

• The most common cause of the vertebrobasilar disease is atherosclerosis. One can help prevent atherosclerosis by following these instructions:

• Do not smoke.
• Eat foods that are low in fat and cholesterol.
• Lose weight if you are overweight.
• Exercise frequently according to your physician’s instructions.
• Lower blood pressure if it is high.
• Lower blood sugar if it is high.

Some people also have bony defects, which, on manipulating the neck, become visible and impinge on the canal with the vertebral artery.