Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracranial haemorrhage which is often unrecognized. There are no specific causes of the syndrome but many clinical conditions and drugs have been observed to be responsible for this syndrome. Often calcium channel blockers (CCBs) are used to relieve the symptoms. Here we will discuss a case of RCVS that was triggered by sexual intercourse. A 42 years old male presented to our hospital with a sudden thunderclap headache following sexual intercourse with vomiting several times. TCD (Transcranial Doppler) ultrasound showed high MFV (Mean flow velocity) in multiple arteries suggestive of moderate to severe stenosis. CT angiogram of the brain revealed multifocal segmental spasm. Then the patient was treated conservatively with analgesics and Nimodipine. The patient made a good recovery following this treatment. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly. All other parameters of general physical examination were within the normal limits. Any focal neurological deficit, the detailed neurological examination did not reveal. There was no neck stiffness or any other sign of meningeal irritation. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly.
| Published in | World Journal of Medical Case Reports (Volume 2, Issue 2) |
| DOI | 10.11648/j.wjmcr.20210202.12 |
| Page(s) | 25-28 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Reversible, Cerebral Vasoconstriction Syndrome, Coital Thunderclap Headache
| [1] | Shih-Pin Chen, Jong-Ling Fuh, Shuu-Jiun Wang. Reversible cerebral vasoconstriction syndrome: an under-recognized clinical emergency. Ther Adv Neurol Disord. 2010 May; 3 (3): 161-71. |
| [2] | Ahsan Sattar, Georgios Manousakis, Matthew B Jensen. Systematic review of reversible cerebral vasoconstriction syndrome. Expert Rev Cardiovasc Ther. 2010 Oct; 8 (10): 1417-21. |
| [3] | Walling A: Headache: headache emergencies. FP Essent. 2018, 473: 21-25. |
| [4] | Aneesh B Singhal, Rula A Hajj-Ali, Mehmet A Topcuoglu, Joshua Fok, James Bena, Donsheng Yang, Leonard H Calabrese. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011 Aug; 68 (8): 1005-12. |
| [5] | Brian S Katz, Jennifer E Fugate, Sebastián F Ameriso, Virginia A Pujol-Lereis, Jay Mandrekar, Kelly D Flemming, David F Kallmes, Alejandro A Rabinstein. Clinical worsening in reversible cerebral vasoconstriction syndrome. JAMA Neurol. 2014 Jan; 71 (1): 68-73. |
| [6] | Rocha EA, Topcuoglu MA, Silva GS, Singhal AB: RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology. 2019, 92: 639-647. 10.1212/WNL.0000000000006917. |
| [7] | Chen S-P, Fuh J-L, Wang S-J: Reversible cerebral vasoconstriction syndrome: an underrecognized clinical emergency. Ther Adv Neurol Disord. 2010, 3: 161-171. |
| [8] | Valença MM, Valença LP, Bordini CA, da Silva WF, Leite JP, Antunes-Rodrigues J, et al. Cerebral vasospasm and headache during sexual intercourse and masturbatory orgasms. Headache 2004; 44: 244-8. |
| [9] | Evers S, Schmidt O, Frese A, Husstedt IW, Ringelstein EB. The cerebral hemodynamics of headache associated with sexual activity. Pain 2003; 102: 73-8. |
| [10] | Kim T, Ahn S, Sohn CH, Seo DW, Kim WY: Reversible cerebral vasoconstriction syndrome at the emergency department. Clin Exp Emerg Med. 2015, 2: 203-209.10.15441/ceem.15.099. |
| [11] | Sattar A, Manousakis G, Jensen MB: Systematic review of reversible cerebral vasoconstriction syndrome. Expert Rev Cardiovasc Ther. 2010, 8: 1417-1421. 10.1586/erc.10.124. |
| [12] | Kato Y, Hayashi T, Mizuno S, et al.: Triptan-induced reversible cerebral vasoconstriction syndrome: two case reports with a literature review. Intern Med. 2016, 23: 3525-3528. 10.2169/internalmedicine.55.7185. |
| [13] | Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D: Reversible cerebral vasoconstriction syndrome, Part 1: epidemiology, pathogenesis, and clinical course. Am J Neuroradiol. 2015, 36: 1392-1399. 10.3174/ajnr. A4214. |
APA Style
Ghulam Kawnayn, Humayun Kabir, Kawsar Ahmed. (2021). Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Post Coital Thunderclap Headache. World Journal of Medical Case Reports, 2(2), 25-28. https://doi.org/10.11648/j.wjmcr.20210202.12
ACS Style
Ghulam Kawnayn; Humayun Kabir; Kawsar Ahmed. Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Post Coital Thunderclap Headache. World J. Med. Case Rep. 2021, 2(2), 25-28. doi: 10.11648/j.wjmcr.20210202.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.wjmcr.20210202.12,
author = {Ghulam Kawnayn and Humayun Kabir and Kawsar Ahmed},
title = {Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Post Coital Thunderclap Headache},
journal = {World Journal of Medical Case Reports},
volume = {2},
number = {2},
pages = {25-28},
doi = {10.11648/j.wjmcr.20210202.12},
url = {https://doi.org/10.11648/j.wjmcr.20210202.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20210202.12},
abstract = {Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracranial haemorrhage which is often unrecognized. There are no specific causes of the syndrome but many clinical conditions and drugs have been observed to be responsible for this syndrome. Often calcium channel blockers (CCBs) are used to relieve the symptoms. Here we will discuss a case of RCVS that was triggered by sexual intercourse. A 42 years old male presented to our hospital with a sudden thunderclap headache following sexual intercourse with vomiting several times. TCD (Transcranial Doppler) ultrasound showed high MFV (Mean flow velocity) in multiple arteries suggestive of moderate to severe stenosis. CT angiogram of the brain revealed multifocal segmental spasm. Then the patient was treated conservatively with analgesics and Nimodipine. The patient made a good recovery following this treatment. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly. All other parameters of general physical examination were within the normal limits. Any focal neurological deficit, the detailed neurological examination did not reveal. There was no neck stiffness or any other sign of meningeal irritation. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly.},
year = {2021}
}
TY - JOUR T1 - Reversible Cerebral Vasoconstriction Syndrome: An Important Cause of Post Coital Thunderclap Headache AU - Ghulam Kawnayn AU - Humayun Kabir AU - Kawsar Ahmed Y1 - 2021/06/22 PY - 2021 N1 - https://doi.org/10.11648/j.wjmcr.20210202.12 DO - 10.11648/j.wjmcr.20210202.12 T2 - World Journal of Medical Case Reports JF - World Journal of Medical Case Reports JO - World Journal of Medical Case Reports SP - 25 EP - 28 PB - Science Publishing Group SN - 2994-726X UR - https://doi.org/10.11648/j.wjmcr.20210202.12 AB - Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracranial haemorrhage which is often unrecognized. There are no specific causes of the syndrome but many clinical conditions and drugs have been observed to be responsible for this syndrome. Often calcium channel blockers (CCBs) are used to relieve the symptoms. Here we will discuss a case of RCVS that was triggered by sexual intercourse. A 42 years old male presented to our hospital with a sudden thunderclap headache following sexual intercourse with vomiting several times. TCD (Transcranial Doppler) ultrasound showed high MFV (Mean flow velocity) in multiple arteries suggestive of moderate to severe stenosis. CT angiogram of the brain revealed multifocal segmental spasm. Then the patient was treated conservatively with analgesics and Nimodipine. The patient made a good recovery following this treatment. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly. All other parameters of general physical examination were within the normal limits. Any focal neurological deficit, the detailed neurological examination did not reveal. There was no neck stiffness or any other sign of meningeal irritation. Reversible cerebral vasoconstriction syndrome remains an underdiagnosed presentation of thunderclap headache which can be triggered by sexual intercourse. It should be an important consideration in cases where SAH has been ruled out. Threatening outcomes could be averted if the excruciating headache is promptly evaluated and managed accordingly. VL - 2 IS - 2 ER -
Information
Email: