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Recurrent Coital ‘Thunderclap’ Headache Associated With Ischaemic Stroke

M. SuttonBrown, W. Morrish, D. Zochodne
Published 2006 · Medicine

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Thunderclap headache has an abrupt and maximal onset. Thunderclap headache can be secondary to subarachnoid haemorrhage, aneurysms without obvious rupture, pituitary apoplexy, venous sinus thrombosis, cervical artery dissection and intracranial hypotension (1–6). Primary thunderclap headache (PTH), a diagnosis to consider when these more serious causes have been excluded, has been described as a distinct entity. When associated with sexual activity, the headache can be classified as primary headache associated with sexual activity (PHSA). Vasospasm may complicate PTH (7). We present a patient with recurrent PHSA associated with cerebral infarction without evidence for vasospasm, vessel occlusion, dissection or other risk factors.
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