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ABSTRACT
Subarachnoid hemorrhage is a leakage of blood, outside the vessel, range to the subarachnoid space. The most common reason of bleeding is intracranial aneurysms. The rupture of aneurysms may occur at the rest, stress, straining, defecation and sexual activity. We report a 51-year old male patient brought to the Emergency Department (ED) with complaints of syncope after waking up. On initial ED evaluation, he was conscious, Glasgow Coma Score was 15/15; and his vital signs, physical and neurological examinations were normal. The patient's history contains that the syncope occurred during the sexual activity and accompanying symptom was headache. Subarachnoid hemorrhage was detected on computed tomography (CT). He was consulted by a neurosurgeon, and operated for aneurysm. Sometimes patients do not provide adequate information as in our case. This can delay the diagnosis and may increase the mortality and morbidity rates. However, detailed anamnesis and consideration of accompanied signs and symptoms may reveal the rare but fatal causes of syncope like SAH. SAH, as a cause of syncope, should be kept in mind in patients who suffer from syncope.
KEY WORDS: Sexual activity, Cerebral aneurysm rupture, Subarachnoid hemorrhage.
Pak J Med Sci July - September 2012 Vol. 28 No. 4 726-728
How to cite this article:
Dogan FS, Dogan A, Guneysel O. Subarachnoid hemorrhage during sexual intercourse. Pak J Med Sci 2012;28(4):726-728
INTRODUCTION
Subarachnoid hemorrhage (SAH) is bleeding from a ruptured vein or artery into subarachnoid space. The most common cause of SAH is intracranial aneurysms.1,2 Aneurysm, as a word, means the expansion of vessels. In every heartbeat, because of the intravascular pressure, the vessels are bulking to outside from the weakest area of vessel's wall and that concludes with aneurysms in time. When the pressure is higher enough, the aneurysm ruptures from the weakest area.1 Rupture mostly happens spontaneously but also happens with cough, straining, excessive activity and sexual activity because of increased pressure.1 Patients mostly describe headache and this is much more severe than the previous ones. Furthermore, they can have some other signs like vomiting, confusion, altered level of consciousness and agitation.1,2 Some of the patients have rapid loss of consciousness following headache and the level of consciousness can be getting worse or better or remaining the same.1,2
We present...