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Could my hairstylist or cough cause a stroke?

May 19, 2016 | Wengui Yu, MD, PhD
Woman getting hair washed at salon

If you Google the phrase “beauty parlor stroke,” you’ll find a number of articles about the purported danger of leaning back in a salon shampoo chair. You may have heard similar stories about neck massage or chiropractic treatment having caused strokes.

As director of the UCI Health Comprehensive Stroke and Cerebrovascular Center, I hear some of the strangest stories. Some scenarios pose real, but rare, stroke risks. Others are highly questionable and unlikely.

I’d like to take this opportunity to separate fact from fiction.

Neck massage or chiropractic treatment

In 2014, the American Heart Association released a statement about the risk of artery damage and stroke following neck manipulation by a chiropractor. The AHA warned that energetic rotations and thrusts could result in cervical artery dissection, a tiny tear in a neck artery that could lead to a stroke should a blood clot form at the site and later travel to the brain.

While there have been cases where chiropractic or other neck manipulation has caused this type of injury, it is relatively uncommon. We see a couple of cases per year. Arterial dissection is more likely to be caused by whiplash injury experienced in a car accident.

Coughing or sneezing hard

We all cough or sneeze, and for most people it poses no problems other than the normal discomfort of allergy, cold or flu symptoms.

However, if you have high blood pressure or have been diagnosed with a cerebral aneurysm (a weakened blood vessel in the brain that could rupture under pressure), forceful coughing, sneezing or blowing your nose could cause a stroke.

This is because such actions may suddenly increase the pressure inside of your brain. So if you have a weakness in your arteries caused by high blood pressure or an existing aneurysm, you could experience a hemorrhagic stroke, where blood leaks into your brain.

We see more patients with this type of stroke in the winter or spring, when flu and allergies arise.

Beauty parlor stroke

There have been reports of people experiencing a stroke following hyperextension of their neck while reclining in a salon shampoo chair. The position reportedly damaged arteries in their neck, causing an arterial dissection similar to the chiropractic scenario described above.

Personally, I’ve never seen a patient who had a stroke from this. It’s extremely uncommon and exaggerated.

Yoga posture

Certain yoga poses — plow, triangle, shoulder stand and headstand — have been said to trigger arterial dissection-related strokes by putting pressure on or causing sudden movements of the neck.

Any change in neck or head position that is sudden or held for a prolonged period presents a potential risk. But yoga itself is a really slow movement exercise. Certain positions, perhaps, could be held too long, but I’ve never seen anyone who had a stroke from doing yoga. Just remember to move slowly and avoid positions that put prolonged or extreme pressure on your neck.

Emotions and stress

There have been reports of people struggling with anger or stress who suddenly experienced a stroke.

Emotions such as anger and anxiety increase your blood pressure and can lead to hypertension, which damages your arteries and can eventually cause a stroke.

Life is often stressful. But if your emotions or stressors boost your blood pressure to unhealthy levels, ask your doctor about lifestyle changes and medications that can help you to manage it.

While there are certainly some unusual causes of stroke, most of them are rare. Rather than becoming fearful of such activity, focus on doing things that are known to have a major impact on reducing your stroke risk — exercising, controlling blood pressure and eating a healthy diet.

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