title: Ischemic stroke during sexual intercourse: a report of 4 cases in persons with patent foramen ovale.
abstract: BACKGROUND
  The association between patent foramen ovale (PFO) and stroke risk in young adults is controversial and poorly understood. Paradoxical embolization through a PFO represents a possible mechanism by which PFO might predispose to stroke.
  
  
  OBJECTIVE
  To describe 4 patients with PFO who experienced the onset of ischemic stroke during sexual intercourse.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary referral stroke clinic.
  
  
  METHODS
  Consecutive patients experiencing stroke during intercourse.
  
  
  RESULTS
  All 4 patients were found to have PFO. Despite a thorough evaluation, no other etiology for stroke was identified.
  
  
  CONCLUSIONS
  We suggest that paradoxical embolization through a PFO due to elevated intrathoracic pressure during sexual activity could be a potential mechanism for stroke in these patients.
authors.affiliation: Department of Neurology, Harborview Medical Center, University of Washington School of Medicine, 325 9th Avenue, Seattle, WA 98104-2499, USA. kjb@u.washington.edu
authors.forename: Kyra
authors.initials: K
authors.lastname: Becker
authors.forename: Elaine
authors.initials: E
authors.lastname: Skalabrin
authors.forename: Danial
authors.initials: D
authors.lastname: Hallam
authors.forename: Edward
authors.initials: E
authors.lastname: Gill
mesh_terms: D000328:Adult; D003075:Coitus; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008297:Male; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology