The dangers of head banging have been closely analyzed by a group of German physicians, according to a case reported in The Lancet.

Among the most hardcore, influential rock’n’roll bands in the world is Motörhead, whose headbanging songs have sent a number of fans to hospital with brain injuries.

Ariyan Pirayesh Islamian and colleagues from the Hannover Medical School analyzed a specific case of a concert goer who developed a serious subdural hematoma (bleeding in the brain) after headbanging to music at a Motörhead concert.

After undergoing a CT scan, the 50-year-old man — who had been complaining of a worsening headache over a two week period — was discovered to have been suffering from the hematoma, which was then removed by surgeons. After about a week, his headache subsided and he overcame his condition.

According to the Cleveland Clinic, headbanging refers to violent, severe movement of the head that follows the rhythm of heavy metal music. Motörhead is well known as one of the most popular heavy metal bands in the world, and headbanging seems to be synonymous with listening to their music.

Headbanging — although often considered rather harmless in small doses — can be dangerous in cases of especially severe and violent movement that lasts for a extended period of time. It can cause serious injuries including whiplash, neck fractures, mediastinal emphysema and carotid artery dissection.

“This case serves as evidence in support of Motörhead‘s reputation as one of the most hardcore rock’n’roll acts on earth, if nothing else because of their music’s contagious speed drive and the hazardous potential for headbanging fans to suffer brain injury,” said Islamian in a statement.