Severe headache during/after sex

JJR512

JJR512

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Recently observed on a call for a male patient, age about 40. Wife called 911 for her husband who was having pain in his head. Turns out he started having pain in his head while they were having sex, but kept going. At the moment of orgasm, the pain got extremely intense, and he essentially collapsed, holding his hands to his head and moaning/crying out in pain. This is what caused the wife to call 911.

The man described the pain as 10/10, like an extremely intense pressure, and at first he said it was all over his head, but he subsequently explained it was more concentrated in both the front of his head (above his eyes going back about a third of the way back along the top), and on the back at the base of his skull.

I was actually doing an observation run on the engine at the time and don't know much more than that. He was transported.

Any idea or guesses what this could be?
 
adamjh3

adamjh3

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A migrane exacerbated by physical exertion? I could understand how that would be really weird to someone who has never experienced migranes.

I could be way off, though.
 
MSDeltaFlt

MSDeltaFlt

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Remember the anatomy of the skull. The area of the skull right above the eyes houses some sinuses. Add any fluid build up in there, the probable position of him being horizontal facing down during sex, and the given increased pressure during sexual excursion, one can very easily get one incredible sinus headache the likes of which might feel like a migraine.

Also, what were his VS? What was his PMH? Any chronic meds? He is 40. Did he also use a little blue pill?

Any of these last questions can also very easily cause said pain during sex.

Some of us aren't 19 anymore.

I'm going to treat this as Ockham's Razor: all things being equal the simplest answer is usually the correct one.
 
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Anjel

Anjel

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You could maybe take it as far as maybe a brain aneurysm? Intense headache. One spot. After a lot of physical exertion. A blood vessel could of ruptured. Or is about to. That's my guess. Could be way off lol

Or it could of just been the sinus headache :)
 
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CAOX3

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JJR512 said:
Recently observed on a call for a male patient, age about 40. Wife called 911 for her husband who was having pain in his head. Turns out he started having pain in his head while they were having sex, but kept going. At the moment of orgasm, the pain got extremely intense, and he essentially collapsed, holding his hands to his head and moaning/crying out in pain. This is what caused the wife to call 911.

The man described the pain as 10/10, like an extremely intense pressure, and at first he said it was all over his head, but he subsequently explained it was more concentrated in both the front of his head (above his eyes going back about a third of the way back along the top), and on the back at the base of his skull.

I was actually doing an observation run on the engine at the time and don't know much more than that. He was transported.

Any idea or guesses what this could be?
Click to expand...

I think you may be confused, its the woman who usually has the headache and its always before sex. :)
 
Aidey

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Anjel1030 said:
You could maybe take it as far as maybe a brain aneurysm? Intense headache. One spot. After a lot of physical exertion. A blood vessel could of ruptured. Or is about to. That's my guess. Could be way off lol

Or it could of just been the sinus headache :)
Click to expand...


It isn't that crazy of a theory. I had a 50s yo male patient who stroked out during intercourse several months ago. Major hemorrhagic stroke, I'm not even sure he lived. His symptoms were 10/10 headache, zero sensation on the left side of the body (but movement was intact) and incontinence.
 
OP
OP
JJR512

JJR512

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Anjel1030 said:
You could maybe take it as far as maybe a brain aneurysm? Intense headache. One spot. After a lot of physical exertion. A blood vessel could of ruptured. Or is about to. That's my guess. Could be way off lol

Or it could of just been the sinus headache :)
Click to expand...

But I don't think it was just one spot; it was originally described as "all over" but later narrowed down to both the entire front of the head as well as the back at the base of the skull. I might have thought about an aneurysm if it was just in one single small spot (although truth be told I don't even know if that would be the case).
 
EMDispatch

EMDispatch

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Any ED drugs involved?
Loss of Consciousness?
Ortho-static test?

High suspicion it relates to vasodialtion from the activity.
 
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emt-mike

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I suffer from migraines and I know that if I have a low grade migraine I wont think much of it, but often, if I exert myself (i.e. sex) it will aggravate the migraine to the point of unbearable pain (10/10)
especially in the base of my head and at my forehead
if it was this guys first migraine, he might not have realized he was suffering from a migraine pre sexual intercourse
 
firetender

firetender

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MCERT1 said:
Any ED drugs involved?
...High suspicion it relates to vasodialtion from the activity.
Click to expand...

Alzheimer's-Viagra Syndrome:

instead of blood rushing to the Little Head, it got confused and went to the Big Head!
 
Afflixion

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Had a patient that was a female and complained of similar issues post intercourse, when we got on seen we checked her and her v/s were all fine other than an excruciating pain in her head she was in her late thirties early forties, and adamantly refused to go to the hospital so she signed a refusal....about an hour later her husband called up and she was unconscious unresponsive, turns out she had a subarachnoid.
 
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Sam Adams

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I'm guessing he didn't want to snuggle and spend the night.

Did all his belongings come with him to the hospital?;)
 
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MediMike

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Maybe he was very well...endowed...and it took a lil' too much blood from upstairs to fill the downstairs
 
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Mobey

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What your describing is called a sex headache or Coital Cephalgia.

As an effect of my Ankylosing Spoldylitis, I have had them in the past.

Basically it is a severe headache than can lead to brief unconciouness (believed to be due to pain). The heaight of the headache is at orgasm, and is VERY painful. The headache usually lasts 30 mins after cesation of activity.

It is believed the headaches are caused by contraction of neck muscles, vascular dilation and contraction, and fluctuating BP.

Sex headaches can also be a sign of hemmorage, meningitis, and other serious illness.

There are links on P1, so I won't post more.
 
bstone

bstone

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Smoke14

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Mobey said:
What your describing is called a sex headache or Coital Cephalgia.

As an effect of my Ankylosing Spoldylitis, I have had them in the past.

Basically it is a severe headache than can lead to brief unconciouness (believed to be due to pain). The heaight of the headache is at orgasm, and is VERY painful. The headache usually lasts 30 mins after cesation of activity.

It is believed the headaches are caused by contraction of neck muscles, vascular dilation and contraction, and fluctuating BP.

Sex headaches can also be a sign of hemmorage, meningitis, and other serious illness.

There are links on P1, so I won't post more.
Click to expand...

Dang, I guess there is a reason to become a priest.
 
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