Stroke at the Hairdresser's chair: A scoping review of the beauty parlor stroke syndrome.

BACKGROUND

Beauty Parlor Stroke Syndrome (BPSS), can present after neck hyperextension during activities like hair shampooing.

PURPOSE: To examine BPSS in the context of activity-induced cerebrovascular accidents, focusing on diagnostic challenges, therapeutic interventions, and implications for emergency care.

MATERIALS AND

METHODS

Literature searches were performed in PubMed, Scopus, and Google Scholar using keywords related to BPSS and neck hyperextension. Inclusion criteria targeted studies with original data on neurological deficits linked to neck hyperextension.

RESULTS

The review identified 22 studies, comprising 54 BPSS cases (79.63 % female, age 13-85). Most cases occurred during beauty parlor visits (42/54), followed by dental visits (8/54) and other settings (4/54). Symptoms varied widely, with dizziness, equilibrium disturbances, and headache being common. Imaging was performed in most cases, with MRI and angiography frequently used. Mechanical impingement and cervical artery dissection were common etiologies. Therapeutic interventions included antiplatelet therapy, anticoagulants, stent revascularization and surgical operations, according to the underlying etiology. Outcomes ranged from full recovery to persistent symptoms and death. Follow-up data was sparse.

CONCLUSIONS

BPSS, while rare, can result from hyperextension during routine activities like salon visits. Its symptoms overlap with those of a classic stroke, emphasizing the importance of thorough history-taking and advanced neuroimaging. Pathophysiology is linked to vascular impingement or dissection, with factors like atherosclerosis and vertebral artery hypoplasia contributing. Treatment is tailored to the underlying cause, ranging from conservative measures to surgical interventions. Emergency physicians should consider BPSS in patients with recent neck hyperextension and acute neurological symptoms.