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The "ろくろ" part of the name has unknown origin, but "首" refers to the neck, which is how this ghost is typically identified. They can appear as regular humans, but can stretch their necks to abnormal lengths.
There's also another type of ろくろっ首 whose head can detach from the neck and fly around freely. This one is called 抜け首 (ぬけくび) or "Escape Neck" and references the head which escapes the neck (and body). Typically illustrated as female, there are some instances of stories of male ろくろっ首.
