{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T23:44:15Z","timestamp":1768002255466,"version":"3.49.0"},"reference-count":91,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:p>Aneurysmal subarachnoid hemorrhage (SAH) is a significant cause of death in young and middle-aged individuals and causes tremendous morbidity in affected patients. Despite the identification of various risk factors, the series of events leading to the formation, growth, and rupture of intracranial aneurysms is poorly understood. Cerebral aneurysm rupture has been associated with sexual intercourse and other forms of physical exercise. In fact, multiple case series reported that coitus was the immediate preceding activity in 3.8\u201314.5% of patients suffering from aneurysmal SAH. This may be related to the large elevations in mean arterial blood pressure that occur in both males and females during sexual intercourse (130\u2013175 and 125\u2013160 mm Hg, respectively). While coitus and physical exercise share important physiological similarities, each may differentially affect the probability that a preformed aneurysm will rupture. In this literature review and synthesis, the authors analyze the physiological human response to sexual intercourse in an effort to delineate those factors that may precipitate aneurysmal rupture. The authors' analysis is based on the original data collected by Masters and Johnson. To the authors' knowledge, this is the first review to address the link between sexual intercourse and intracranial aneurysmal rupture. While actual measurements of the physiological variables relevant to SAH were not performed in this article, the authors make reasonable assumptions based on the available data to help elucidate the mechanism of sexually induced aneurysmal rupture.<\/jats:p>","DOI":"10.3171\/2010.4.jns09975","type":"journal-article","created":{"date-parts":[[2010,6,11]],"date-time":"2010-06-11T14:01:38Z","timestamp":1276264898000},"page":"969-977","source":"Crossref","is-referenced-by-count":48,"title":["Sexual intercourse and cerebral aneurysmal rupture: potential mechanisms and precipitants"],"prefix":"10.3171","volume":"114","author":[{"given":"Matthew R.","family":"Reynolds","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon T.","family":"Willie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory J.","family":"Zipfel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph G.","family":"Dacey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns09975","series-title":"Principles of Neurology","first-page":"669","author":"Adams","year":"1989"},{"key":"b2-jns09975","series-title":"Stroke","first-page":"1771","article-title":"Triggers of subarachnoid hemorrhage: role of physical exertion, smoking, and alcohol in the Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS)","volume":"34","author":"Anderson","year":"2003"},{"key":"b3-jns09975","series-title":"Acta Neurochir (Wien)","first-page":"141","article-title":"Rerupture of intracranial aneurysms during angiography","volume":"98","author":"Aoyagi","year":"1989"},{"key":"b4-jns09975","series-title":"Neurosurgery","first-page":"722","article-title":"Controlled pressure-volume factors in the enlargement of intracranial aneurysms","volume":"24","author":"Austin","year":"1989"},{"key":"b5-jns09975","series-title":"J Appl Physiol","first-page":"469","article-title":"Physiologic responses during coitus","volume":"9","author":"Bartlett","year":"1956"},{"key":"b6-jns09975","series-title":"Neurosurgery","first-page":"664","article-title":"Spontaneous subarachnoid hemorrhage in young adults","volume":"21","author":"Biller","year":"1987"},{"key":"b7-jns09975","series-title":"The Heart Rate","author":"Boas","year":"1932"},{"key":"b8-jns09975","series-title":"Anaesthesist","first-page":"152","article-title":"[Acute intracranial subarachnoid hemorrhage following repeated spinal anesthesia.]","volume":"41","author":"B\u00f6ttiger","year":"1992"},{"key":"b9-jns09975","series-title":"Phys Ther","first-page":"1682","article-title":"Effects of positioning and exercise on intracranial pressure in a neurosurgical intensive care unit","volume":"77","author":"Brimioulle","year":"1997"},{"key":"b10-jns09975","series-title":"N Engl J Med","first-page":"671","article-title":"Pheochromocytoma with rupture of an intracranial aneurysm; report of a case","volume":"247","author":"Browne","year":"1952"},{"key":"b11-jns09975","series-title":"Mayo Clin Proc","first-page":"445","article-title":"Peak exercise blood pressure stratified by age and gender in apparently healthy subjects","volume":"71","author":"Daida","year":"1996"},{"key":"b12-jns09975","series-title":"Am J Public Health","first-page":"676","article-title":"Incidence of hypertension in the Framingham Study","volume":"78","author":"Dannenberg","year":"1988"},{"key":"b13-jns09975","series-title":"Handbook of Physiology. 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