Traumatic Brain Injury After Music-Associated Head Banging: A Scoping Review

OBJECTIVE: To examine the literature to understand the extent that music-associated head banging (MAHB), a common form of self-expression that involves rhythmically swinging one's head to music, is a risk factor for traumatic brain injury (TBI), to identify areas for further research, and to inform primary prevention strategies. DATA SOURCES: A comprehensive search of several databases from database inception to June 30, 2021, was designed and conducted by an experienced librarian with input from study investigators. STUDY SELECTION: Study inclusion criteria encompassed all study designs evaluating TBI associated with MAHB. Two independent reviewers reviewed all titles, abstracts, and full texts. DATA EXTRACTION: Data were extracted by 2 independent reviewers, and results were summarized descriptively. DATA SYNTHESIS: Of 407 eligible studies, 13 met inclusion criteria. All included studies were case reports from multiple countries describing a case of moderate-severe TBI occurring as a direct consequence of MAHB. Of the individuals reported (n=13), they had 1 or more of the following: traumatic subdural hematoma (n=8), internal carotid artery dissection (n=2), basilar artery thrombosis (n=2), traumatic vertebral artery aneurism (n=1), or intracerebral hemorrhage (n=1). No studies were found involving mild TBI after MAHB. CONCLUSIONS: This scoping review suggests that MAHB is a risk factor for moderate-severe TBI, although the incidence of mild TBI after MAHB remains unknown. Additional research is needed to understand the association of TBI after MAHB through the spectrum of injury severity, including the potential sequelae of multiple subconcussive injuries.