Could my hairstylist or cough cause a stroke?


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.

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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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  • — Update: 25-12-2022 — We found an additional article The Effect of Sneezing on the Reduction of Infarct Volume and the Improvement of Neurological Deficits in Male Rats from the website www.ncbi.nlm.nih.gov for the keyword sneeze a mini stroke.

    Introduction

    Stroke is defined as acute focal damage to the central nervous system, divided into three categories of cerebral infarction, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage. Stroke is one of the remarkable causes of disability and death in the world. The WHO definition of stroke in the 1970s has been globally accepted. The clinical symptoms are rapidly developing signs of focal or universal disturbances in the function of the brain that last longer than 24 h or even lead to death, and do not have other apparent causes other than that of vascular origin. Cerebral infarction is known to occur as focal ischemia within the perfusion territory of specified arteries due to a clot or stenosis. On the other hand, ICH can be defined as the blood accumulation in the cerebral parenchyma or the ventricles that is not caused by traumatic accidents. The ICH has a lower prevalence of embolism but higher morbidity and mortality.[1]

    The mechanism involved in sneezing reflex is similar to the Valsalva maneuver, in which venous return to the heart is reduced, and the autonomic system is involved by changing the tone of the vessels.[2,3,4]

    The response of the cardiovascular system to Valsalva maneuver is divided into several phases. The first phase is the start of the strain, and during this phase, we could see the increased intrathoracic pressure, compressed significant vessels and subsequently increased the pressure of the aorta. Changes in cardiac output in this phase are insignificant. In the second phase, an increase in intrathoracic pressure causes compression of the veins at the thoracic inlet and disrupts the venous return. The blood volume of the heart decreases by 25%–30%, resulting in a decrease in the preload of the heart and ultimately lowers the stroke volume. Then, arterial pressure and subsequently, pulse pressure are reduced. These changes cause sympathetic stimulation and vasoconstriction. As mean aorta pressure and pulse pressure are reduced, the carotid sinus baroreceptors are stimulated and this stimulation results in the sympathetic activation, heart rate elevation, and increased resistance of the arteries and veins outside the thorax. As a result, cardiac output and blood pressure (BP) are raised, and the sudden and the short-term occurrence of these processes cause the excessive increase in arterial pressure.[3,5]

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    Stroke is a significant cause of long-term disability due to neurological impairment,[6] and there are no broadly effective therapies to rescue neurological deficits. Sneezing increases intrathoracic and intraabdominal pressure, resulting in acute hypertension and transiently elevated cerebral blood flow.[7] Induced sneezing in the early period, following the stroke, may be a feasible method to restore cerebral blood flow because it can be evoked reliably even in unconscious subjects.

    Induced sneezing and concomitant acute hypertension during the 1st h of recovery after ischemic stroke can improve recovery, presumably because the cerebral BP elevation causes recanalization of blocked vessels[8] and early vascular reperfusion is strongly related to clinical outcomes.[9] Furthermore, the rise in BP increases blood flow to ischemic regions.[10] Some studies have stated that Valsalva maneuver may increase the risk of ICH, and a few case report studies demonstrated that some individuals had blown O-ring in their heads while lifting weights, presumably under Valsalva maneuver. It is stated that sneezing could result in increased intrathoracic pressure and BP and intracranial pressure (ICP) and therefore, sneezing may predispose ICH. Hence, sneezing could be useful in the embolic stroke but is a risk factor for hemorrhagic stroke.[11,12,13,14]

    Of the numerous animal stroke models, the embolic stroke model induced by natural clots is most relevant to the pathophysiological situation in patients with ischemic stroke.[15] Thus, we tested whether induced sneezing in rats could decrease infarct volume and improve neurological deficits, following clot occlusion of the middle cerebral artery (MCA).


    — Update: 25-12-2022 — We found an additional article Do You Sneeze After Eating? Here Are The Reasons Why from the website thegrandhealthcare.com for the keyword sneeze a mini stroke.

    A sneeze is a natural response to irritation in a person’s nasal cavity. Sneezing can also be triggered by eating food. Sneezing is often the result of inhaling something that irritates the nose, but it can also be caused by breathing in cold air, looking into bright lights, or eating food.

    Sneeze a mini stroke

    Sneeze: Eating Triggers, Gustatory Rhinitis

    There are several possible causes for a person to sneeze after meals. One of them is gustatory rhinitis.

    This condition specifically causes a person to sneeze after eating. Rhinitis is a general term for irritation or swelling that happens in the nose.

    Gustatory rhinitis is not related to allergies, so it is known as nonallergic rhinitis. It happens when the nasal nerves are hypersensitive to environmental triggers.

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    Symptoms of gustatory rhinitis usually come on within minutes of eating and can include:

    • sneezing
    • a runny nose
    • nasal congestion or stuffiness

    Gustatory rhinitis is especially common after eating spicy or hot foods including:

    • hot peppers
    • curry
    • wasabi
    • hot soups

    There are special receptors in the lining of the nose that detect capsaicin, a compound found in chili peppers. When these fibers detect the presence of capsaicin, they can trigger one or more sneezes.

    You can prevent these symptoms by avoiding trigger foods. Keep a food and symptom diary to find out what foods cause this condition in you.

    Sneeze: Snatiation Reflex

    Some people may sneeze after eating a large meal. This is known as the snatiation reflex, which is a combination of the words ‘sneeze’ and ‘satiation.’

    You experience this reflex when your stomach is full and becomes stretched. This may result in one sneeze or a sneezing fit. The cause is unknown, but there may be a genetic component.

    Sneeze: Food Allergies

    Sometimes when a person eats foods they are especially sensitive or allergic to, they can sneeze. Other symptoms may include itchy eyes or a mild skin rash.

    In severe instances, a person may have a severe allergic reaction known as anaphylaxis that causes extreme swelling and difficulty breathing. Some of the most common foods that can trigger allergies are milk, eggs, peanuts, soy, and tree nuts.

    Sneeze: A Cold or Flu

    Also, sometimes a person may have a cold or other illness that can cause them to sneeze after eating. The two occurrences, eating and sneezing, may seem related but are separate.

    Sneeze: Prevention Strategies After Eating A Meal

    • Holding one’s breath while counting to 10, or as long as a person can comfortably hold their breath. This helps to inhibit the sneezing reflex.
    • Pinching the bridge of the nose to keep the sneeze from occurring. This has a similar effect as someone holding their breath.
    • Avoiding foods known to cause sneezing or foods that a person is allergic to. If a person is unsure which foods trigger this response, a doctor may recommend keeping a food diary or doing an elimination diet.
    • Eating smaller meals throughout the day instead of several large ones, as large meals can trigger the snatiation reflex.
    • Taking over-the-counter (OTC) decongestants, such as pseudoephedrine, to reduce any nasal swelling or sensitivity that could cause sneezing after eating.
    • OTC antihistamine nasal sprays may also help to reduce the incidence of sneezing after eating. These sprays block the release of histamines, which are inflammatory compounds that can cause sneezing.

    Conclusion

    A sneeze or consistent sneezing after eating is rarely cause for medical concern, but can be annoying and distracting. It can also cause droplets to spread in the air, which risks the spread of viruses and bacteria, so you may wish to reduce the likelihood after eating.

    Currently, there is no guaranteed cure for gustatory rhinitis or snatiation. In many cases, you can prevent this reflex by steering clear of certain foods or avoiding eating large meals.

    References

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    About the Author: Tung Chi