Abstract
A 22-year-old man without significant past medical history noticed a right occipital headache, paresthesia of the right side of the body including the face, and right-upper homonymous quadrantanopsia after sexual intercourse. Brain MRI showed acute infarctions in the right occipital lobe and thalamus. MRA revealed a pearl-and-string sign in the right posterior cerebral artery. He was diagnosed as having cerebral infarctions due to a postcoital posterior cerebral artery dissection and was treated with aspirin. His clinical course was uneventful, and the irregularity of his right posterior cerebral artery was improved in an MRA image one year after the onset. Cerebral artery dissection is an important cause of cerebral infarction in the young, and sexual intercourse can trigger it. Therefore, it is important to take a history carefully when you suspect a young patient of having a cerebral artery dissection. And in general, a benign nonorganic headache related to sexual intercourse is known as a primary headache associated with sexual activity, but we should take into account that cerebral artery dissection can be a cause of headache related to sexual intercourse.
