Quiet Riot advised the world in 1983 to “Bang your head—mental health will drive you mad.” They might have added that the headbanging may cause one’s brain to bleed.

Doctors in Germany reported treating a Motörhead fan for brain injury resulting from his headbanging habit but stressed that the case is unusual and that the risk of brain injury from this type of activity is low.

At the beginning of the year, a 50-year-old man was treated at Hannover Medical School after he complained of constant and worsening headaches. He had no history of head injuries or drug use. After further questioning, he revealed that he had been a long-time headbanger and had most recently did a lot of headbanging at a Motörhead concert he attended with his son.

Doctors ordered a magnetic resonance imaging (MRI) scan and upon examination of the results found that the man’s brain was bleeding. He needed to have a hole drilled through his skull through which the blood could be drained. The patient’s headaches subsided, and doctors found a benign cyst in followup scans that might have predisposed the man to his injury.

“We are not against headbanging,” said Dr. Ariyan Pirayesh Islamian, one of the doctors who treated the man. “The risk of injury is very, very low. But I think if [our patient] had [gone] to a classical concert, this would not have happened.”

Bleeding in the head causes displacement of brain tissue and an increase of intracranial pressure that can slowly choke off the vital blood supply to the brain. Left untreated, brain bleeds can be debilitating and even fatal. Brain bleeds occur when the brain bumps against the inside wall of the skull violently enough to rupture a blood vessel.

The case of the headbanging brain-bleeder is described this week in the journal The Lancet.