Hola Gustavo:
En relación a este mismo tema te mando este articulo que me pareció interesante.
Saludos
Dr. Miguel Osorno
De: amn-epilepsia-mexico@googlegroups.com [mailto:amn-epilepsia-mexico@googlegroups.com] En nombre de J. Gustavo Vega Gama
Enviado el: viernes, 21 de octubre de 2011 08:45 p.m.
Para: ameinnn@googlegroups.com; amn-epilepsia-mexico@googlegroups.com; jgustavo51.ameinnnblg@blogger.com
Asunto: [amn-epilepsia-mexico:518] CEFALEA BENIGNA DEL COITO
Apreciados compañeros,
A veces nos hemos sometido al reto diagnóstico de la cefalea que sucede
durante el coito, cuando esta ocurre "in crescendo" y es preorgásmica generalmente
no constituye un reto diagnóstico o terapéutico, pero cuando ésta es explosiva,
durante el orgasmo nos puede hacer sospechar en hemorragia subaracnoidea
espontánea por rotura de aneurisma, sin embargo, el curso clínico orienta el
diagnóstico cuando la cefalea desaparece en su totalidad.
De cualquier manera se imponen los estudios de imagen para descartar esa
posibilidad. La decisión de hacer punción lumbar esta supeditada al contexto
clínico y a las circunstancias específicas de cada caso.
Va esta pequeña revisión, con algunos artículos de acceso a texto completo,
de acceso libre a petición de una compañera de la lista.
Saludos muy cordiales
y feliz fin de semana
jgustavo51 
jgustavo1951 
jgustavo
This message contains search results at the U.S. National Library of Medicine (NLM).
Sender's message: Benign orgasmic cephalgia.
Sent on: Fri Oct 21 21:14:27 2011 Search: Benign orgasmic cephalgia.
| PubMed Results |
| 1. | J Clin Neurosci. 2010 Oct;17(10):1349-51. Epub 2010 Jul 23. Isolated thunderclap headache during sex: Orgasmic headache or reversible cerebral vasoconstriction syndrome?Hu CM, Lin YJ, Fan YK, Chen SP, Lai TH.SourceDepartment of Neurology, Mackay Memorial Hospital, Taipei, Taiwan. AbstractOrgasmic headache (OH) is an "explosive" headache that occurs at orgasm. Historically, it was considered benign with no treatment needed. Reversible cerebral vasoconstriction syndrome (RCVS) refers to a group of disorders characterized by recurrent thunderclap headache (TCH) and multifocal vasoconstriction. Patients who have RCVS often recover completely, but some may have persistent neurological deficits. We report a 34-year-old woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy, making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography showed segmental vasoconstriction. We concluded that she could be considered to have either OH or RCVS. This patient suggests the theory that OH could be a presentation of RCVS. Given that RCVS is potentially treatable, early recognition by clinicians is vital in order to prevent devastating complications. Copyright 2010 Elsevier Ltd. All rights reserved. |
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| 2. | J Emerg Med. 2009 Oct 7. [Epub ahead of print] Thunderclap Headache with Orgasm: A Case of Basilar Artery Dissection Associated with Sexual Intercourse.Delasobera BE, Osborn SR, Davis JE.SourceDepartment of Emergency Medicine, Georgetown University Hospital and Washington Hospital Center, Washington, DC. AbstractBackground: Headaches associated with sexual intercourse (coital cephalgia) have many different causes and are often divided in the literature into pre-orgasmic and orgasmic headaches. Objective: To present a case of orgasmic headache caused by a basilar artery dissection and to present a literature-based guide to the diagnosis and management of patients presenting with headaches related to sexual activity. Case Report: We report the case of a 34-year-old man without significant past medical history who presented to the Emergency Department with two episodes of orgasmic headache caused by basilar artery dissection. Conclusions: The cause of headaches related to sexual activity range from the benign to the life-threatening. Due to the dynamics of cerebral blood flow during sexual intercourse, basilar artery dissections and aneurysms should be considered in patients with sudden-onset headaches during orgasm. Appropriate brain imaging and, possibly, lumbar puncture may assist in identifying potentially life-threatening causes of coital headaches. |
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| 3. | Headache. 2008 Jun;48(6):967-71. Call-Fleming syndrome and orgasmic cephalgia.Keyrouz S, Dhar R, Axelrod Y.SourceUniversity of Arkansas for Medical Sciences, Little Rock, AR, USA. AbstractWe report a case of Call-Fleming syndrome complicating orgasmic thunderclap headache. Recognizing this benign condition that mimics symptoms of subarachnoid hemorrhage prevents unwarranted invasive investigations and interventions that may cause harm. |
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| 4. | Ginekol Pol. 2005 Dec;76(12):995-9. [Primary headache associated with sexual activity].[Article in Polish] Domitrz I. SourceKlinika Neurologii, Akademia Medyczna, Warszawa. domitrz@amwaw.edu.pl AbstractBenign coital headache is known as a rare type of primary headache related to sexual activity. The pathogenesis of this type of headache remains unknown. Clinical manifestation is typical and connected with three phases of sexual activity. Coital cephalalgia is divided into two subtypes: preorgasmic and orgasmic headache. Some authors specifie the third type--postural type. Preorgasmic headache starts as a dull bilateral ache and increases with sexual excitement. Orgasmic headache has sudden, intense character and occurs at orgasm. Postural headache has been reported to develop after coitus. The author describes four cases of different types of sexual headache, which were effectively treated. Indomethacin was effective in all patients as direct treatment and propranolol was effective in patients to whom it was administrated as preventive treatment. |
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| 5. | Cephalalgia. 2005 Dec;25(12):1182-3. A patient with orgasmic headaches converting to concurrent orgasmic and benign exertional headaches.Brilla R, Evers S.SourceDepartment of Neurology, Aurora Sheboygan Clinic, Sheboygan, WI 53081, USA. roland.brilla@aurora.org |
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| 6. | Headache. 2003 Jul-Aug;43(7):808. Not-so-benign sexual headache.Lasoasa DS.SourceUniversity Clinical Hospital Lozano Blesa, Zaragoza, Spain. |
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| 7. | Neurologia. 2000 Aug-Sep;15(7):317-8. [High cerebrospinal fluid protein levels and intracranial pressure limit values in a patient with benign sexual headache].[Article in Spanish] Sastre-Garriga J, Arenillas JF, Tintoré M, Titus F, Montalbán X, Codina A. |
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| 8. | BMJ. 1992 Nov 7;305(6862):1129. Natural course of benign coital headache.Ostergaard JR, Kraft M.SourceDepartment of Pediatrics A, University Hospital of Arhus, Denmark. |
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| 9. | Neurology. 1992 Mar;42(3 Suppl 2):16-21. Symptomatic and prophylactic treatment of migraine and tension-type headache.Schulman EA, Silberstein SD.SourceTemple University School of Medicine, Philadelphia, Pennsylvania. AbstractPharmacotherapy is the mainstay for patients with persistent headaches. When simple analgesics can no longer be used, combination analgesics are prescribed. Symptomatic medications also include antiemetics, ergot derivatives, corticosteroids, neuroleptics, and narcotics. Nonsteroidal anti-inflammatory drugs are commonly used both symptomatically and prophylactically, and are the treatment of choice for menstrual migraine. Exertional migraine, benign orgasmic cephalalgia, chronic paroxysmal hemicrania, cough headache, and "ice-pick" headache are treated with indomethacin. Ergotamine tartrate is often recommended when simple or combination analgesics do not relieve headaches. Dihydroergotamine (DHE) is effective for treating intractable headache; because it has fewer side effects than ergotamine, it is tolerated by patients unable to tolerate other ergotamine preparations. DHE is administered IM and, for occasional use, patients can be taught self-injection. Repetitive IV DHE therapy for chronic severe headaches requires hospitalization; most patients become headache-free within 3 days. Patients who refuse hospitalization, do not respond to the drug, or are not suitable candidates for DHE therapy may receive a short course of a corticosteroid, a neuroleptic or, rarely, a narcotic. For frequent headaches, prophylactic treatment usually begins with a tricyclic antidepressant or a beta blocker. |
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| 10. | Med Clin North Am. 1991 May;75(3):733-47. Cough, exertional, and other miscellaneous headaches.Sands GH, Newman L, Lipton R.SourceLong Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York. AbstractWe have discussed several miscellaneous headache disorders not associated with structural brain disease. The first group included those headaches provoked by "exertional" triggers in various forms. These include benign cough headache, BEH, and headache associated with sexual activity. The IHS diagnostic criteria were discussed. Benign exertional headache and cough headache were discussed together because of their substantial similarities. In general, BEH is characterized by severe, short-lived pain after coughing, sneezing, lifting a burden, sexual activity, or other similar brief effort. Structural disease of the brain or skull was the most important differential diagnosis for these disorders, with posterior fossa mass lesions being identified as the most common organic etiology. Magnetic resonance imaging with special attention to the posterior fossa and foramen magnum is the preferred method for evaluating these patients. Indomethacin is the treatment of choice. The headache associated with sexual activity is dull in the early phases of sexual excitement and becomes intense at orgasm. This headache is unpredictable in occurrence. Like BEH, the headache associated with sexual activity can be a manifestation of structural disease. Subarachnoid hemorrhage must be excluded, by CT scanning and CSF examination, in patients with the sexual headache. Benign headache associated with sexual activity has been successfully treated with indomethacin and beta-blockers. The second miscellaneous group of headache disorders includes those provoked by eating something cold or food additives, and by environmental stimuli. Idiopathic stabbing headache does not have a known trigger and appears frequently in migraineurs. Its occurrence may also herald the termination of an attack of cluster headache. Indomethacin treatment provides significant relief. Three headaches triggered by substances that are eaten were reviewed: ingestion of a cold stimulus, nitrate/nitrite-induced headache, and MSG-induced headache. For the most part, avoidance of these stimuli can prevent the associated headache. Lastly, we reviewed headache provoked by high altitude and hypoxia. The headache is part of the syndrome of AMS during its early or benign stage and the later malignant stage of HACE. The pain can be exacerbated by exercise. The best treatment is prevention via slow ascent and avoidance of respiratory depressants. Acetazolamide and dexamethasone have proved useful in preventing this syndrome. |
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| 11. | J Neurol Neurosurg Psychiatry. 1991 May;54(5):417-21. Benign vascular sexual headache and exertional headache: interrelationships and long term prognosis.Silbert PL, Edis RH, Stewart-Wynne EG, Gubbay SS.SourceDepartment of Neurology, Royal Perth Hospital, Western Australia. AbstractThere is a definite relationship between the vascular type of benign sexual headache and benign exertional headache. Forty five patients with benign vascular sexual headache were reviewed. Twenty seven (60%) experienced benign vascular sexual headache alone and eighteen (40%) had experienced both benign vascular sexual headache and benign exertional headache on at least one occasion. The mean age was 34.3 years with a male:female ratio of 5.4:1. Thirty patients with a history of benign vascular sexual headache were followed for an average of 74 months. A personal history of migraine was found in 47% of cases and a family history of migraine in 30%. Forty one per cent of patients with benign vascular sexual headache alone had recurrences after diagnosis, and stress and fatigue were considered major contributing factors to the initial and recurrent headache. Nine patients had experienced benign vascular sexual headache and benign exertional headache within 72 hours of each other on at least one occasion, often with a residual headache between the two. Four patients experienced their benign vascular sexual headache and benign exertional headache separated by months to years. The prognosis of benign vascular sexual headache and the clinical and possible pathophysiological relationships between benign vascular sexual headache and benign exertional headache are discussed. Knowledge of the interrelationships of these varieties of headache is valuable in the counselling of patients. |
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| 12. | Aust N Z J Med. 1989 Oct;19(5):466-8. Angiographically demonstrated arterial spasm in a case of benign sexual headache and benign exertional headache.Silbert PL, Hankey GJ, Prentice DA, Apsimon HT.SourceDepartment of General Medicine, Royal Perth Hospital, WA, Australia. AbstractBenign headaches related to sexual activity and exertion are being recognised with increasing frequency. We wish to report a case of benign sexual headache (Type 2) and benign exertional headache, occurring sequentially in the same patient. Multiple areas of cerebral arterial spasm were demonstrable on angiography. This observation would support the concept that benign sexual headache (Type 2) and benign exertional headache may have a similar pathophysiology. |
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| 13. | Cephalalgia. 1988 Dec;8(4):265-8. Complicated coital cephalalgia. Three cases with benign evolution.Martinez JM, Roig C, Arboix A.SourceNeurology Service, Hospital Sta Creu i Sant Pau, Autonomous University, Barcelona, Spain. AbstractThree patients with a history of migraine and type-II coital cephalalgia with signs of vertebrobasilar deficiency are presented. Extensive studies including angiography did not show any vascular malformation. Together with the few reports in the literature our cases outline a benign form of complicated coital cephalalgia, possibly resulting from ischaemic disturbances triggered by haemodynamic changes occurring in orgasm. |
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| 14. | Arch Neurol. 1986 Nov;43(11):1158-60. Benign sexual headache within a family.Johns DR.AbstractThe occurrence of the vascular type of benign sexual headache (BSH) is described within members of a family. The most severely affected of the four sisters was successfully treated with propranolol hydrochloride prophylaxis. The literature on headache related to sexual activity is reviewed and the clinical features of BSH are formulated. The familial occurrence is put forth as further evidence to consider the vascular type of BSH as a migraine variant. |
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| 15. | Ugeskr Laeger. 1979 Sep 3;141(36):2452-3. [Benign orgastic headache. Review and 6 cases].[Article in Danish] Tfelt-Hansen P, Therkelsen J. |
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| 16. | J Neurol Neurosurg Psychiatry. 1976 Dec;39(12):1226-30. Headaches related to sexual activity.Lance JW.AbstractTwenty-one patients experienced headache related to sexual activity. Two varieties of headache could be distinguished from the clinical histories. The first, developing as sexual excitement mount, had the characteristics of muscle contraction headache. The second, severe, throbbing or 'explosive' in character, occurring at the time of orgasm, was presumably of vascular origin associated with a hyperdynamic circulatory state. Two of the patients with the latter type of headache had each experienced episodes of cerebral vascular insufficiency on one occasion which subsequently resolved. A third patient in this category had a past history of drop attacks. No evidence of any structural lesion was obtained on clinical examination or investigation, including cerebral angiography in seven patients. Eighteen patients have been followed up for periods of two to seven years without any serious intracranial disorder becoming apparent. While the possibility of intracranial vascular or other lesions must always be borne in mind, there appears to be a syndrome of headache associated with sexual excitement where no organic change can be demonstrated, analogous to benign cough headache and benign exertional headache. |
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| 17. | Headache. 1974 Oct;14(3):164-5. The benign and malignant forms of orgasmic cephalgia.Lundberg PO, Osterman PO. |
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| 18. | Headache. 1974 Jan;13(4):181-7. Benign orgasmic cephalgia.Paulson GW, Klawans HL Jr. |
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| 19. | Trans Am Neurol Assoc. 1973;98:295-7. Benign orgasmic cephalgia.Paulson GW, Klawans HL Jr. |
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