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Unusual case of a woman who suffered stroke during sex
Date:9/14/2008

late to receive tPA given intravenously. But there was a chance the clot buster drug still could work if it were delivered directly into the affected blood vessel in the brain.

An interventional neuroradiologist inserted a catheter (thin tube) into a groin artery, and guided it up to the spot in the brain where the clot was lodged. After the catheter delivered the tPA, the clot began to dissolve.

The improvement was immediate and dramatic. When the woman arrived at Loyola, her stroke score was 13, on a scale of 1 to 43, with 43 representing the most catastrophic outcome. Within an hour of treatment, her score dropped to 5. Her stroke score dropped to 3 after 12 hours and to 1 after two months. Her only lingering symptoms were a slight weakening of her facial muscle and minimal impairment of her left hand, said Dr. Simona Velicu, who assisted Biller. Velicu, a neurology resident at Stritch, is lead author of the case report.

Doctors prescribed aspirin and a blood thinner, advised the woman to stop taking birth control pills and scheduled a follow-up procedure to repair the hole in her heart. The defect, called a patent foramen ovale (PFO), occurs in about 1 in 4 adults. While in many people a PFO will never cause problems, the defect might be associated with an increased risk of stroke. How these patients should be managed remains controversial.

Dr. Fred Leya, an interventional cardiologist, used a catheter to place a device in the woman's heart that plugged the hole. Leya has done about 150 PFO repairs, and is participating with his neurology colleagues in a clinical trial of a leading repair device. Leya is a professor of medicine in the Department of Cardiology at Loyola's Stritch School of Medicine.

There are no statistics on the number of patients who have experienced strokes during sexual intercourse. While it appears that such strokes are rare in young adults, a few case reports have been reported. A 2004 report in
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Contact: Jim Ritter
jritter@lumc.edu
708-216-2445
Loyola University Health System
Source:Eurekalert

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