Post-coital intra-cerebral venous hemorrhage in a 78-year-old man with jugular valve incompetence: a case report

Abstract

IntroductionSpontaneous intra-cerebral hemorrhage can occur in patients with venous disease due to obstructed venous outflow.Case presentationWe report the case of a 78-year-old Caucasian man with jugular valve incompetence who experienced an intra-cerebral temporo-occipital hemorrhage following sexual intercourse. He had no other risk factors for an intra-cerebral hemorrhage.ConclusionsTo the best of our knowledge, this is the first case of intra-cerebral hemorrhage due to jugular valve incompetence in association with the physical exertion associated with sexual intercourse.

Review of Severe Headache after Sexual Activity with a Case Presentation

“…Literatürde bu tür olgular bildirilmiştir. Albano ve arkadaşları seksüel aktivite sonrası 78 yaşında erkek hastada intraserebral venöz hemoraji gelişen bir olgu bildirmişlerdir (9). De-Giorgio ve arkadaşları sildenafil kullanımı sonrasında serebral arter rüptürü sonrasında ölümle sonuçlanan SAK olgusu paylaşmışlardır (10).…”

Sexual activity as a trigger for intracranial hemorrhage

“…The body of literature on the topic is little more than a handful of case reports and small series [2,13,14,32,39]. While these reports bring attention to the topic, the small number of patients makes meaningful discussion and conclusion challenging.…”

“…However, evidence suggests that non-aneurysmal perimesecephalic hemorrhages are more commonly associated with straining at the time of Only illicit drug use and the use of antithrombotics and/or phosphodiesterase-5 inhibitors are reported ictus than aneurysmal SAH [3,19,44], potentially explaining its occurrence during sexual activity. The Valsalva maneuver has been implicated as a trigger for aneurysm rupture [38], non-aneurysmal perimesencephalic hemorrhage [44], and venous cerebral hemorrhage [2]. The maneuver increases intrathoracic pressure, which in turn decreases venous return to the heart leading to transient cerebral venous hypertension and elevated intracranial pressure [17,33].…”

“…The maneuver increases intrathoracic pressure, which in turn decreases venous return to the heart leading to transient cerebral venous hypertension and elevated intracranial pressure [17,33]. Transmission of intrathoracic pressure to cerebral venous circulation is hypothesized to underlie venous cerebral hemorrhage in some cases, particularly in the presence of jugular valve incompetence [1,2]. While a similar mechanism is proposed for non-aneurysmal perimesencephalic hemorrhage [44], aneurysm rupture is likely precipitated at the end of the maneuver when elevated arterial blood pressure is met with a drop in venous and intracranial cerebrospinal fluid pressure, leading to increased transmural pressure across the aneurysm dome [36,38].…”

Caveolin‑1 modulates hypertensive vascular remodeling via regulation of the Notch pathway

“…Hypertension, which promotes the occurrence of cerebral venous dysfunction-mediated brain tissue damage, such as venous sinus thrombosis, venous cerebral infarction, venous cerebral hemorrhage, periventricular venous disease, venous neurocytotoxicity, neurodegeneration and demyelination, is one of the primary risk factors of cerebrovascular disease (1)(2)(3)(4). Vascular remodeling has been shown to be important for the progression of hypertension-mediated cerebrovascular disease (5).…”