Abstract
Orgasmic headache (OH) is an “explosive” headache that occurs at orgasm. Historically,
it was considered benign with no treatment needed. Reversible cerebral vasoconstriction
syndrome (RCVS) refers to a group of disorders characterized by recurrent thunderclap
headache (TCH) and multifocal vasoconstriction. Patients who have RCVS often recover
completely, but some may have persistent neurological deficits. We report a 34-year-old
woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the
diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy,
making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography
showed segmental vasoconstriction. We concluded that she could be considered to have
either OH or RCVS. This patient suggests the theory that OH could be a presentation
of RCVS. Given that RCVS is potentially treatable, early recognition by clinicians
is vital in order to prevent devastating complications.
Keywords
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Article info
Publication history
Accepted:
January 31,
2010
Received:
September 8,
2009
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.