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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References
Headache Classification Committee of the International Headache Society. The international classification of headache disorders. 2nd ed. Cephalalgia 2004; 24(Suppl. 1):9–160.
- Headaches related to sexual activity.J Neurol Neurosurg Psychiatry. 1976; 39: 1226-1230
- Benign orgasmic cephalgia.Headache. 1974; 13: 181-187
- Benign exertional headache/benign sexual headache: a disorder of myogenic cerebrovascular autoregulation?.Headache. 1997; 37: 597-598
- Orgasmic headache with transient basilar artery vasospasm.Headache. 2004; 44: 710-712
- Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasm.Headache. 2004; 44: 244-248
- Headache associated with sexual activity.Neurology. 2003; 61: 796-800
- Narrative review: reversible cerebral vasoconstriction syndromes.Ann Intern Med. 2007; 146: 34-44
- Reversible cerebral segmental vasoconstriction.Stroke. 1988; 19: 1159-1170
- The clinical radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients.Brain. 2007; 130: 3091-3101
- Reversible cerebral vasoconstriction syndrome.J Clin Neurosci. 2009; 16: 147-150
- Call–Fleming syndrome and orgasmic cephalgia.Headache. 2008; 48: 967-971
- Transcranial color Doppler for reversible cerebral vasoconstriction syndromes.Ann Neurol. 2008; 63: 751-757
- Recurrent primary thunderclap headache and benign CNS angiopathy: spectra of the same disorder?.Neurology. 2006; 67: 2164-2169
- A review of the subjective effects of MDMA/ecstasy.Addiction. 2006; 101: 933-947
- Nimodipine for treatment of primary thunderclap headache.Neurology. 2004; 62: 1414-1416
Article info
Publication history
Accepted:
January 31,
2010
Received:
September 8,
2009
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
