#Stroke after the neck-crack & head massage by a barber after haircut
1. I saw a 22-year old being brought to the emergency room on a stretcher (1999 @OffCMCVellore. He had developed dizziness, followed by weakness of limbs and breathing difficulty after neck-crack by barber.

2. He was perfectly well prior to going for hair cut. Symptoms started soon after head massage and neck-crack by the barber. MRI brain showed infarcts in left cerebellar hemisphere and medulla. MR angiogram showed features of left vertebral artery dissection.

3. He was intubated & mechanically ventilated. Anticoagulation with heparin was started. He was gradually weaned off the ventilator and was discharged after 7 days with minor deficits. He made a gradual recovery after three months with warfarin and physiotherapy.
#MedTwitter

Take home message
Neck crack and twisting of neck by a barber can be risky. It can lead to rupture of arteries in the neck, as well as damage to nerves (cervical nerve roots and phrenic nerve). Similar cases have also been reported after chiropractic maneuvers.