Paradoxical Embolism to the Central Nervous System After Sexual Intercourse in a Young Woman with a Complex Atrial Septal Abnormality

Ischemic stroke during sexual intercourse is an unusual occurrence. We report the evaluation and treatment of a young woman on oral contraceptives, with a complex atrial septal abnormality and right lower extremity deep vein thrombus, who had an ischemic stroke during sexual intercourse. Successful treatment was accomplished with administration of intra-arterial tissue plasminogen activator and subsequent transvascular occlusion of the atrial septal abnormality.