Doctors Lounge - Neurology Answers
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Forum Name: Neurology Topics
|krissydb7 - Mon Nov 10, 2008 10:19 pm||
On Oct. 15 my boyfriend (age 30) had to be taken by life flight to a university hospital in our area after he had an accident on his mountain bike. He doesn't know what happened but he fell off of his bike and hit his head either on the curb or driveway and after a CT scan was done they found both swelling and bleeding in his brain along with a fracture in the temporal bone. He was in ICU for 8 days and was improving until his sodium levels became low (124). The doctors attributed that to being caused by syndrome of inappropriate anti-diuretic hormone. After his sodium levels returned to a normal level he was then moved to a regular room where he remained for 2 more days. During his stay in the hospital they also diagnosed him with Mafan's (his brother also has this). He has now been home for a little over 2 weeks and is doing very well, his headache's have gone away and as far as the doctor's can tell he won't have any lasting effects caused by the brain injury. No rehab was needed, and he never was unconscious at any time in the hospital only for approx. one min. when the accident occurred. When discharged, the doctors told him no strenuous activity for a month and he has been resting since he got home. But we are both concerned for the future with his physical well-being. Are there any risks associated with having sex, and how long should you wait after such a brain injury has occurred? He says that he feels much better than he did when he first came home, and feels back to normal. I am concerned that it is too soon to be sexually active after such a trauma occurred to his body, and he does not want to go into his doctor and ask him about this topic.
|John Kenyon, CNA - Tue Dec 02, 2008 11:18 pm||
While the ideal would be to ask his doctor directly, since the doctor would know all the specifics of his case, I also realize a lot of people feel very uncomfortable with this line of questioning, so I'll try to give you some guidelines to use. First, the exertion involved with an average sexual encounter would be the equivalent of climbing a flight of stairs. This isn't considered strenuous as a rule, but is exertion. The problem that arises is that with sex usually comes both an increase in blood pressure and cardiac output, and, if it takes place horizontally (as it frequently does, at least at some point), then intracranial pressure is increased on top of the already (though temporarily) increased blood pressure.
This could pose a problem for a while yet, since there was apparently a bleed on the brain. While things have are no doubt coming along well, it wouldn't be a good time to test how well the healing process is coming along. (This also, and especially, applies to heavy lifting or other straining, which also increases pressure inside the head). In a few weeks (actually by now) it should be perfectly safe to ease back into the regular routine, but he should be aware of anything that doesn't feel right (head-wise, especially).
You mention also he's been diagnosed with Marfan syndrome. I hope he will have this followed proactively, as sometimes this can cause serious problems with the eyes, joints and, most especially, with the heart and great blood vessels. There is no specific contraindication regarding sex, but he should be aware he is more vultnerable than average to problems in the above-named areas and should have a chest x-ray and echocardiogram probably yearly.
I hope this is helpful to you. Best of luck to you both.
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