In an account documented in BMJ Case Stories, a 61-year-old girl skilled a extreme headache throughout sexual exercise, which alarmingly turned out to be a symptom of a critical mind hemorrhage.Coital cephalalgia, often known as headache related to sexual exercise (HSA) or just “sexual headache,” happens in affiliation with sexual exercise, manifesting as a sudden, intense headache. Whereas usually innocent and self-resolving, it calls for consideration to rule out extra critical situations.To be recognized with sexual headache, a affected person should expertise not less than two situations of headache which might be particularly triggered by sexual exercise. These complications should improve in depth with sexual pleasure or have a sudden extreme onset at orgasm, can last as long as 24 hours if extreme or 72 hours if delicate, and can’t be attributed to every other medical situation.Its prevalence ranges between 0.25% and 1% within the basic populace, suggesting it’s not as uncommon as one may assume. Regardless of its potential to indicate critical well being points, its main kind is normally benign and unrelated to any underlying dysfunction.The case report detailed the experiences of a 61-year-old girl in search of medical assist for a extreme headache that emerged immediately throughout sexual activity. Described as a ten out of 10 in depth and situated within the occipital area, this headache didn’t subside with over-the-counter ache relievers.Additional complicating her scenario had been visible disturbances that prompted her to go to a hospital, the place imaging assessments revealed a right-sided occipital mind hemorrhage.Upon switch to a specialised facility, additional examinations, together with magnetic resonance imaging (MRI) and computed tomography angiography (CTA), confirmed the hemorrhage with out indicating any particular underlying trigger.Regardless of intensive testing for autoimmune issues, vascular ailments, and different potential causes, no predisposing situations had been recognized. This lack of an identifiable trigger was puzzling, as secondary sexual complications sometimes stem from identifiable points corresponding to vascular malformations or hypertension, none of which had been current on this case.Her remedy strategy was conservative, specializing in monitoring and rehabilitation quite than surgical intervention. Remarkably, the affected person made a full restoration, regaining her imaginative and prescient and returning to her regular state of well being inside a yr, with out the necessity for ongoing remedy.The case report, “A not so pleased ending: coital cephalgia ensuing from an acute non-traumatic intraparenchymal haemorrhage in a feminine with no comorbidities,” was authored by Hafez Mohammad Ammar Abdullah, Uzma Ikhtiar Khan, Ezza Tariq, and Muhammad Omar.