Baby-Shakers Ball

Mediastinal Emphysema After Head-Banging in a Rock Artist: Pseudo Shaken-Baby Syndrome in Adulthood

There are many health hazards involved in heavy metal, including sexually transmitted disease, pyrotechnic burns, rabid bat ingestion and decapitation. But the genre’s most popular stage move also carries with it a considerable amount of medical risk. Studies stretching back to 1983 have reported some very scary side effects of head-banging, including deaths from carotid dissection and subdural hemorrhage.  But a new Japanese study of a professional head-banging who survived his injuries suggests that the practice should be considered a grown-up version of an early-life danger: shaken-baby syndrome.

The case study, published in The Annals of Thoracic Surgery, describes a 34-year-old guitarist from a popular “visual-kei” band – a subculture of Japanese rock that appears to be descended from American hair metal. The patient came to the doctors with recurrent neck and chest pain, which commonly flared up after his concerts. After a CT scan, the doctors discovered mediastinal emphysema – essentially a pocket of air where it shouldn’t be, between the lungs and chest. The guitarist was sent home with painkillers and antibiotics, which (according to my doctor wife) are given to prevent infection in case these air pockets are the result of “esophageal rupture.”

While the patient recovered after this treatment, the doctors sought the cause of the unusual injury through reviewing concert DVDs featuring his band. They noticed “that he shook his head violently throughout the concerts” and that many members of the audience did as well. Digging into the literature, they found a similar case of mediastinal emphysema in soldiers that vigorously shouted “Hooah!” during a training exercise while trying to outperform their peers.

All this injurious, violent behavior reminds the doctors of the “head-banging, head-rolling and body-rocking” commonly observed in infants. In extreme or abusive cases, these motions can cause Shaken Baby Syndrome, the symptoms of which squarely overlap with the various reports of head-banging damage from the literature – with the disturbing additions of retinal hemorrhage and failure to thrive (both excellent heavy metal band names, incidentally).

To avoid such injuries, the doctors helpfully recommend playing slower-tempo music instead of heavy metal, head-banging every other beat instead of on every single one, or wearing “personal protective equipment.” Perhaps it’s not a coincidence that the drummer in this visual-kei video is wearing a neck brace? But while many public health campaigns are underway to warn parents about the dangers of shaken baby syndrome, the authors of this paper seem much more pessimistic about the potential of a head-banging hazards awareness campaign.

“Unfortunately, it is difficult, if not impossible, to change the habits of heavy metal aficionados,” the article concludes. Metal health will drive you mad.

Matsuzaki S., Tsunoda K., Chong T. & Hamaguchi R. (2012). Mediastinal Emphysema After Head-Banging in a Rock Artist: Pseudo Shaken-Baby Syndrome in Adulthood, The Annals of Thoracic Surgery, 94 (6) 2113-2114. DOI: