Sexual activity as a trigger for intracranial hemorrhage

Area of Science:

• Neurology
• Cardiology
• Sexual Health

Background:

• Intracranial hemorrhage (ICH) has been anecdotally linked to sexual activity.
• The physiologic sexual response may act as a trigger for ICH.

Purpose of the Study:

• To present a case series of patients experiencing ICH following sexual activity.
• To elucidate the role of the sexual response in triggering ICH.

Main Methods:

• Retrospective review of medical records.
• Identification of patients with ICH temporally related to sexual activity.
• Collection and reporting of clinical and radiographic data.

Main Results:

• Sixteen patients with non-traumatic ICH related to sexual activity were identified.
• Common causes included aneurysmal subarachnoid hemorrhage (50%), angiogram-negative subarachnoid hemorrhage (25%), ruptured arteriovenous malformation (12.5%), and intracerebral hemorrhage (12.5%).
• The average age was 49.9 years, with most cases linked to male-female intercourse.

Conclusions:

• Sexual activity-related ICH is a rare condition with varied underlying causes.
• Dramatic increases in arterial blood pressure during sexual response are the probable mechanism linking sexual activity to ICH.