Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms.
BACKGROUND
The pathophysiology of the explosive type of headache associated with sexual activity is not completely understood. Five reported cases of patients with thunderclap headache, precipitated by sexual activity, in association with concomitant cerebral arterial narrowing, were found in the literature.


METHODS
A 44-year-old woman with both coital and masturbatory headaches during orgasm associated with segmental reversible cerebral artery vasospasm was investigated. Cerebral anatomy and eventual spasm was documented by magnetic resonance imaging or digital angiography before, during, and after resolution of the orgasmic headache-vasospasm clinical manifestation.


CONCLUSIONS
Findings of cerebral arterial narrowing, presented by some patients shortly after orgasmic headache attacks, support the hypothesis that segmental vasospasm may exert a role in the pathogenesis of this uncommon type of headache. The literature is reviewed, and possible mechanisms underlying the development of orgasmic headache are discussed.
Valença
Marcelo M
MM
Division of Neurology and Neurosurgery, Department of Neuropsychiatry, CCS, Federal University of Pernambuco, Recife, PE, Brazil.
Valença
Luciana P A A
LP
Bordini
Carlos A
CA
da Silva
Wilson Farias
WF
Leite
João P
JP
Antunes-Rodrigues
José
J
Speciali
José G
JG
D000208:Acute Disease; D000328:Adult; D002533:Cerebral Angiography; D003075:Coitus / Q000502:physiology*; D005260:Female; D006261:Headache / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008418:Masturbation / Q000503:physiopathology*; D009948:Orgasm / Q000502:physiology*; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000503:physiopathology*