A patient with a 20 year history of primary orgasmic headache is described who, after suffering an unusually severe episode of orgasmic headache was found to have a middle cerebral artery dissection. This unusual association of primary and secondary orgasmic headache emphasises the need for a thorough diagnostic examination when the orgasmic headache differs from that of previous episodes or is associated with neurological symptoms.
- OH, orgasmic headache
- MRI, magnetic resonance imaging
- SAH, subarachnoid haemorrhage
- MRA, magnetic resonance angiography
- MCA, middle cerebral artery
- dissecting aneurysm
- middle cerebral artery
- orgasmic headache
- digital substraction angiography
- magnetic resonance angiography
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Competing interests: none declared
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