gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Chronic subdural hematoma secondary to head-banging

Meeting Abstract

  • Ariyan Pirayesh Islamian - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • Manolis Polemikos - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • Nesrin Uksul - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • Joachim K. Krauss - Klinik für Neurochirurgie, Medizinische Hochschule Hannover

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 114

doi: 10.3205/14dgnc510, urn:nbn:de:0183-14dgnc5104

Published: May 13, 2014

© 2014 Islamian et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: “Head-banging” (HB) describes a dance form including the violent movement of the head to the rhythm of rock music, most commonly seen in the heavy metal genre. A thorough review of the literature yielded three cases of subdural hematomas described in association with intensive HB. We report of a patient with an arachnoidal cyst (AC) and chronic subdural hematoma (cSDH) following excessive HB.

Results: A 50-year-old male hard rock enthusiast presented with a 2-week history of increasing headache. There was no history of head trauma, but the patient reported that he had performed HB during a rock show 4 weeks earlier. Results of the neurological examination and laboratory studies, including coagulation screening, were unremarkable. Cranial computed tomography (CCT) demonstrated an extensive right hemispheric cSDH with a midline shift of approximately 15 mm. The patient underwent burr hole evacuation of the cSDH and closed system subdural drainage that was continued for 6 days after surgery. During the postoperative course his headache subsided and he was discharged on the 9th postoperative day with no neurological deficits. At 2-month clinical follow-up the patient was free of neurological symptoms. The complementary CCT showed in addition to a complete resolution of the subdural collection an AC of the ipsilateral middle cranial fossa (grade I according to Galassi et al., 1982) that was initially interpreted as a bleeding at the tip of the temporal lobe in extension of the right hemispheric cSDH.

Conclusions: Our case illustrates the impact of HB on the development of subdural hematoma. It further highlights the importance of a subdural hematoma as a differential diagnosis in patients with diagnosed asymptomatic AC showing signs of increased intracranial pressure even after minor head affection. Conversely, the importance of a thorough investigation for small ACs in young patients with subdural hematoma is emphasized.