Thursday 11 January 2018

Is beauty parlor stroke syndrome going to kill me?

Rarely, extending your neck over the ledge of a sink can cut off blood flow to the brain, writes Katie Heaney in The Atlantic. Read on: 

The last time I got a haircut, I spent the five or so minutes it took for my stylist to wash my hair thinking about death. Contemplating my mortality is not so unusual an activity for me, but there are places I have counted on for a break, and historically the hair salon was one of them. I devote too much time to worrying I’m about to succumb to all kinds of unlikely health crises, but not even I could think up anything likely to kill me in the hair salon. But then I read an article (well, four articles) about something called “beauty parlor stroke syndrome.”

Besides being a term perfectly engineered to startle those of us with easily startled dispositions, “beauty parlor stroke syndrome” describes a phenomenon by which extending one’s neck over the ledge of a sink can diminish blood supply to the brain, potentially causing a stroke.

The phenomenon reentered the news last year after a woman suffered stroke symptoms not long after visiting her San Diego salon, and subsequently sued for damages. Media coverage of the incident gave mixed messages as to the so-called syndrome’s likelihood. BuzzFeed’s story called it “so rare,” but also quoted the plaintiff, Elizabeth Smith (understandably looking for answers), as saying that “80 percent” of stylists knew “you could have a stroke getting your hair washed.” That Smith arrived at this figure by asking an unspecified number of friends to ask their hair stylists if they’d ever heard of beauty parlor stroke syndrome matters a lot in a scientific sense, but for pseudo-hypochondriacs like me, seeing that kind of number—80 percent!—outweighs all reason. Now my mind has transformed it from an extremely rare medical event unlikely to affect anyone but elderly and other at-risk patients into a widespread beauty-salon conspiracy. All along I thought my hair stylist was a nice lady with great lipstick. Now, I wonder, is she knowingly and carelessly putting my life at risk each time she tells me to lean back? I fidgeted all the way through my most recent hair washing, trying to hold my neck above the sink as though mere neck-to-sink contact was the thing that might kill me.

I do not want to suffer every time I go to the hair salon from here on out. Nor do I wish to offend my hairstylist by telling her why I have become so squirmy. It is very hard to find a hairstylist you like, and you can’t go around accusing them of attempted murder and still hope they’ll give you a decent hair cut. So I got in touch with an actual stroke expert in hopes he might talk some sense into me.

Richard Bernstein is the medical director of the Comprehensive Stroke Center at Northwestern Memorial Hospital in Chicago, and delivers his expertise to me in the patient-if-slightly brusque tone to which I am accustomed in every doctor I speak to. On a hunch I asked him if “beauty parlor stroke syndrome” is a real medical term, and he said no — getting one’s hair washed is merely one possibility in a range of options that cause the actual medical condition properly known as “vertebral artery dissection from hyperextension of the neck,” a considerably less grabby, though ultimately scarier name. What seems to happen is that certain movements of or pressures on the neck can result in a flap-like tear in the vertebral artery, which supplies blood to the brain. From there blood enters (and thereby thickens) the arterial wall, which can cause a blood clot, impeding blood flow and potentially causing a stroke.

“It is so rare that it’s a waste of time to worry about it. It’s so unlikely, and there’s really nothing you can do to prevent it.”
It’s a phenomenon that isn’t altogether understood, Bernstein explained, but it can happen as a result of a wide variety of innocuous activities—not just getting your hair washed, but getting out of bed wrong in the morning, stretching, and even sneezing.

This is the type of thing doctors tell you to make you feel better, but it does not make me feel better. I am known to be a loud and forceful sneezer, like my father before me, frequently startling those in my vicinity. Was he telling me that I had to worry about getting a stroke every time I sneezed, too? Well, no, not really.

“It is so rare,” he said, “that it’s a waste of time to worry about it. It’s so unlikely, and there’s really nothing you can do to prevent it.” I asked him if he was sure—would putting extra towels under one’s neck at the salon do anything, maybe?

“Well, since getting up in the morning can make it happen, you better not sleep, either,” Bernstein replied. Point taken.

Having noticed in my reading that one sign of the artist formerly known as beauty parlor stroke syndrome is neck pain, I asked Bernstein what else people should be on the lookout for. He first explained that while neck pain can be a symptom of vertebral artery dissection, it’s extremely unlikely to be the dominant or the only one. “Neck pain can be caused by a great number of things,” he said. “That’s almost never a cause for concern.” More troubling are the other, more recognized symptoms of a stroke—facial slackness, paralysis on one side of the body, loss of coordination and/or loss of vision. If you’re experiencing any of those symptoms, you should definitely head to the ER, he said. And while it never hurts to protect one’s neck, Bernstein cautions that there is only so much that can be done toward prevention, and you’re likely at no greater risk in a hair salon than you are in your very own bed. That is supposed to be comforting, but I understand if it’s not.

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