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Beauty Parlor #Stroke Syndrome

1. I recently saw a 50-year old woman with symptoms of dizziness, nausea & vomiting, which started during her hair wash with shampoo in a beauty parlor. Initially, she was taken to a gastroenterologist, who treated her symptomatically.
#Medtwitter
2. Symptoms did not improve, the next day she developed mild imbalance while walking. She was referred for my opinion. She had mild right cerebellar signs. MRI brain revealed infarct in right posterior inferior cerebellar territory, MR angiogram showed left vertebral hypoplasia
3. A diagnosis of #beauty #parlor stroke syndrome involving right PICA territory was made. Possible mechanism is kinking of vertebral artery during hyperextension & turning of neck towards wash-basin while washing hair with shampoo. She had well controlled #Hypertension too.
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