Etiologies and Mechanisms of Ischemic Stroke Associated with Sexual Intercourse: A Literature Review

2021 ◽  
pp. 1-9
Author(s):  
Shouyue Jin ◽  
Qingwei Yang ◽  
Xingyu Chen ◽  
Yajing Zhan
Keyword(s):  
Ischemic Stroke ◽  
Literature Review ◽  
Sexual Intercourse ◽  
Illicit Drugs ◽  
Early Recognition ◽  
Warning Sign ◽  
Paroxysmal Sympathetic Hyperactivity ◽  
Cerebral Vasoconstriction ◽  
Search Terms ◽  
Special Events

<b><i>Background:</i></b> Exposure to some special events, also called stroke triggers, can precipitate the onset of ischemic stroke (IS). Previous studies have presented preliminary hypotheses about sexual intercourse as a trigger of IS in predisposed individuals, but the mechanisms of IS associated with sexual intercourse are still not well defined. This literature review summarizes the etiologies and mechanisms of IS associated with sexual intercourse. Further studies on stroke triggers are warranted, and early recognition and appropriate preventive strategies directed against the short-term risks posed by stroke triggers may complement the long-term risk factor reduction approach. <b><i>Methods:</i></b> Articles were selected from PubMed (1946–2021) and Web of Science Core Collection (1990–2021) using the following search terms: ischemic stroke, ischaemic stroke, stroke, cerebral infarction, cerebral ischemia, cerebral embolism, embolism, sexual intercourse, sexual activity, intercourse, coitus, coition, and coital. <b><i>Results:</i></b> A total of 20 studies, which included 26 patients with IS associated with sexual intercourse, were included. This literature review found that IS associated with sexual intercourse is not rare but has not received enough attention, and paradoxical embolization and postcoital arterial dissection are common etiologies. Other etiologies include drug usage (such as sexual adjuvant drugs and illicit drugs), paroxysmal sympathetic hyperactivity, and reversible cerebral vasoconstriction syndrome. <b><i>Discussion/Conclusion:</i></b> Sexual intercourse should be considered an important trigger for IS. Clinicians should be aware that IS associated with sexual intercourse is not subjective but may be a warning sign of multiple etiologies and mechanisms.

scholarly journals Triggers of Ischemic Stroke: Results from the Stroke Onset Pilot Study

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 366-367
Author(s):  
Murray A Mittleman ◽  
Barbara Voetsch ◽  
Louis R Caplan
Keyword(s):  
Ischemic Stroke ◽  
Pilot Study ◽  
Sexual Intercourse ◽  
Illicit Drugs ◽  
Small Vessel Disease ◽  
Smoking Behavior ◽  
Physical Exertion ◽  
Structured Interview ◽  
Stroke Onset ◽  
Case Crossover

P153 Despite progress in the identification of risk factors for stroke, relatively little is known about the immediate precipitants or triggers of acute ischemic stroke (IS). We therefore conducted a pilot study to determine the presence of potential triggers within 24 hours preceding the onset of IS to establish the feasibility of conducting a case-crossover study of potential triggers of IS. The case-crossover design is an epidemiologic method that uses each patient as his/her own control, developed to evaluate the effect of potential triggers on the incidence of acute events. During the time of the pilot, we recruited 50 patients (88% of all eligible hospitalized patients) mean age 62±16 years, including 32% women. Patients were typically interviewed in hospital within 2 or 3 days of the onset of IS. The structured interview covered use of medications, caffeinated beverages, alcohol, smoking behavior, illicit drugs including marijuana and cocaine, timing of meals particularly unusually large meals, episodes of straining for defecation or urination, sexual intercourse and heavy physical exertion. Separate questions emphasized lifting heavy objects, and psychometric evaluations of anger, anxiety and depression. Large vessel atherothrombotic lesions were responsible for 39% of strokes, cardioembolic sources for 28%, small vessel disease (lacunar infarcts) for 22%, and other etiologies for 11%. The prevalence of exposure in the year prior to stroke varied from 10% for marijuana to 88% for caffeinated beverages. Exposure to potential triggers in the 24 hours before stroke onset was reported in over 30% of cases, including heavy exertion ≥ 6 METs (8%), lifting ≥ 50lbs (10%), straining for urination or defecation (4%), sexual intercourse (2%), outbursts of anger (4%), alcohol (28%), and marijuana (6%). The Stroke Onset Study Pilot demonstrates that potential triggers are present in approximately one-third of patients with IS. A larger study is required to assess whether external stressors can trigger the onset of stroke. Identifying and understanding the mechanisms by which particular exposures trigger the onset of stroke may lead to novel preventive strategies.

scholarly journals Cerebral fat embolization with paroxysmal sympathetic hyperactivity syndrome and septic shock at high altitude: a case report and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Min Li ◽  
Gang Zhu ◽  
Hao Guo ◽  
Shun Nan Ge ◽  
Guo Dong Gao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
High Altitude ◽  
Fat Embolism ◽  
Neurological Rehabilitation ◽  
Case Presentation ◽  
Sympathetic Hyperactivity ◽  
Paroxysmal Sympathetic Hyperactivity

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.

scholarly journals Unhealthy life habits associated with self-induced vomiting and laxative misuse in Brazilian adolescents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana Luiza Gomes de Souza ◽  
Alexandre Aparecido de Almeida ◽  
Priscilla Rayanne E. Silva Noll ◽  
Matias Noll
Keyword(s):  
Eating Disorders ◽  
Sexual Intercourse ◽  
Illicit Drugs ◽  
Social Cognitive ◽  
Strong Association ◽  
Educational History ◽  
First Sexual Intercourse ◽  
Psychosocial Disorders ◽  
Life Habits ◽  
Physical Changes

AbstractAdolescence is a stage in life characterized by important social, cognitive, and physical changes. Adolescents are vulnerable to various psychosocial disorders, including eating disorders. We aimed to investigate the association between unhealthy habits, sociodemographic characteristics, and the practice of self-induced vomiting or laxative misuse in a representative sample of Brazilian adolescent girls and boys. Data from 102,072 students who participated in the National Adolescent School-based Health Survey were analyzed using the dependent variable: presence or absence of self-induced vomiting and/or laxative misuse; independent variables: consumption of unhealthy and high-calorie food items, age during first sexual intercourse, and the use of tobacco, alcohol, and/or illicit drugs. Associations between exposure and outcome were estimated using Poisson’s regression models stratified by sex, and including region, school, age group, and mother's educational history as adjustment variables. Eating ultra-processed foods and age during first sexual intercourse were associated with self-induced vomiting and laxative misuse only for girls; all other variables (consuming unhealthy foods and using legal or illicit substances) were associated with these behaviors for both sexes after applying adjustment variables. Early interventions focusing on changing unhealthy behaviors may prevent development of eating disorders in adolescents. Our findings demonstrate a strong association of many unhealthy habits with laxative misuse and self-induced vomiting practices in Brazilian adolescents.

scholarly journals Delayed uterine rupture occurred 4 weeks after cesarean section following sexual intercourse: A case report and literature review

2013 ◽  
Vol 52 (3) ◽  
pp. 411-414 ◽  
Author(s):  
Hsing-Fen Tsai ◽  
Hsiang-Lin Song ◽  
Wen-Chung Chen ◽  
Chia-Ming Chang ◽  
Chiung-Hsin Chang ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Cesarean Section ◽  
Sexual Intercourse ◽  
Uterine Rupture

Abstract P686: Ischemic Stroke in Reversible Cerebral Vasoconstriction Syndrome

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Aayushi Garg ◽  
Amjad Elmashala ◽  
Santiago Ortega
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Survey Design ◽  
Inpatient Rehabilitation ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Hospital Charges ◽  
Multivariable Logistic Regression Analysis ◽  
Cerebral Vasoconstriction ◽  
History Of

Introduction: Ischemic stroke is the cause for major morbidity and mortality in reversible cerebral vasoconstriction syndrome (RCVS). While there is evidence to suggest that ischemic stroke in RCVS is associated with proximal vasoconstriction, it is still unclear why some patients develop ischemic lesions. The aim of this study was to evaluate the risk factors and outcomes of ischemic stroke in RCVS. Methods: We utilized the Nationwide Readmissions Database 2016-2017 to identify all hospitalizations with the discharge diagnosis of RCVS. Occurrence of acute ischemic stroke was identified. Hospitalizations with the diagnosis of hemorrhagic stroke were excluded. Survey design methods were used to generate national estimates. Independent predictors of ischemic stroke were analyzed using multivariable logistic regression analysis with results expressed as odds ratio (OR) and 95% confidence intervals (CI). Results: Among the total 1,065 hospitalizations for RCVS during the study period (mean±SD age: 49.0±16.7 years, female 69.7%), 267 (25.1%) had occurrence of acute ischemic stroke. Patients with ischemic stroke were more likely to have history of hypertension (OR 2.33, 95% CI 1.51-3.60), diabetes (OR 1.81, 95% CI 1.11-2.98), and tobacco use (OR 1.64, 95% CI 1.16-2.33) and less likely to have a history of migraine (OR 0.56, 95% CI 0.35-0.90). Patients with stroke were more likely to develop cerebral edema. They also had longer hospital stay, higher hospital charges, and lower likelihood of being discharged to home or inpatient rehabilitation facility. They had higher in-hospital mortality rate, the difference was however not statistically significant. Conclusion: In conclusion, ischemic stroke affects nearly 25% of patients with RCVS and is associated with an increased rate of other neurologic complications and worse functional outcomes. Patients with traditional cerebrovascular risk factors might have a higher predisposition for developing the ischemic lesions.

scholarly journals Merci mechanical thrombectomy retriever for acute ischemic stroke therapy: Literature review

Neurology ◽  
2012 ◽  
Vol 79 (Issue 13, Supplement 1) ◽  
pp. S126-S134 ◽  
Author(s):  
A. Alshekhlee ◽  
D. J. Pandya ◽  
J. English ◽  
O. O. Zaidat ◽  
N. Mueller ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Literature Review ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Stroke Therapy

Characteristics of Pediatric Stroke and Association of Delayed Diagnosis with Mortality in a Mexican Tertiary Care Hospital

2021 ◽  
Author(s):  
Gerardo Garza-Alatorre ◽  
Ana Luisa Carrion-Garcia ◽  
Alfredo Falcon-Delgado ◽  
Elda Carolina Garza-Davila ◽  
Angel R Martinez-Ponce de Leon ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Early Recognition ◽  
Tertiary Care ◽  
Delayed Diagnosis ◽  
University Hospital ◽  
Pediatric Stroke ◽  
Care Hospital ◽  
Continuous Increase ◽  
Common Risk Factors

Abstract Background and objectives Pediatric cerebrovascular disease carries significant morbidity and mortality. Early recognition of a pediatric stroke as well and its most common risk factors are important, but that diagnosis is often delayed. It is believed that the incidence in our center is higher than it appears. This study aims to assess the incidence and characteristics of the pediatric stroke in our university hospital. Likewise, this study seeks to evaluate if a longer symptoms-to-diagnosis time is associated with mortality in patients with ischemic stroke. Methods A retrospective study including children with stroke admitted to the UANL University Hospital from January 2013 to December 2016. Results A total of 41 patients and 46 stroke episodes were admitted. About 45.7% had an ischemic stroke and 54.3% had a hemorrhagic stroke. A mortality of 24.4% and a morbidity of 60.9% were recorded. Regarding ischemic and hemorrhagic stroke, an increased symptoms-to-diagnosis time and a higher mortality were obtained with a relative risk of 2.667 (95% confidence interval [CI]: 1.09–6.524, p = 0.013) and 8.0 (95% CI: 2.18–29.24, p = < 0.0001), respectively. A continuous increase in the incidence rate, ranging from 4.57 to 13.21 per 1,000 admissions comparing the first period (2013) versus the last period (2016), p = 0.02, was found in our center. Conclusions Pediatric stroke is a rare disease; however, its incidence shows a continuous increase. More awareness toward pediatric stroke is needed.

scholarly journals School Climate as a Universal Intervention to Prevent Substance Use Initiation in Early Adolescence: A Longitudinal Study

2020 ◽  
Vol 47 (3) ◽  
pp. 402-411
Author(s):  
Shay M. Daily ◽  
Michael J. Mann ◽  
Christa L. Lilly ◽  
Thomas K. Bias ◽  
Megan L. Smith ◽  
...  
Keyword(s):  
Substance Use ◽  
School Climate ◽  
Illicit Drugs ◽  
Warning Sign ◽  
Student Behaviors ◽  
School Students ◽  
Eighth Grade Students ◽  
Curve Modeling ◽  
Positive School Climate ◽  
Substance Use Initiation

Initiation of substance use often starts during adolescence, with tobacco and alcohol use frequently preceding the use of marijuana and other illicit drugs. Studies suggest that a positive school climate may prevent substance use while promoting healthy student behaviors. The purpose of this study was to determine the longitudinal associations between school climate and substance use initiation in a group of middle school students. Parallel latent growth curve modeling was used to examine changes among study variables longitudinally using a sample of 2,097 sixth-, seventh-, and eighth-grade students across 16 regional schools located in three counties in West Virginia. Results suggest that a positive school climate may prevent substance use initiation (β = −0.07 to −0.25, p < .01). However, perceptions of school climate decreased on their own over time (β = −0.28 to −0.66, p < .01). Furthermore, substance use initiation also increased as students grew older (β = 0.96 to 0.99, p < .01) and reduced the effects of school climate longitudinally (β = −0.07 to −0.24, p < .01). Early substance use initiation may be a warning sign of other underlying student issues and requires additional school support to foster student success. Findings suggest that a positive school climate may delay substance use initiation and promote school success. School climate may, therefore, be useful as an intervention to support school-based health promotion.

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