Pseudoephedrine-induced Hemorrhage Associated with a Cerebral Vascular Malformation
| Autor: | Steven K. Baker, Jamie E. Silva, Ken K.S. Lam |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Intracranial Arteriovenous Malformations
Male medicine.medical_specialty Treatment outcome Brain Edema Comorbidity Intracranial Hemorrhage Hypertensive X ray computed medicine Humans Sinusitis Sympathomimetics Ephedrine Gynecology business.industry Vascular malformation General Medicine Cerebral Arteries Middle Aged medicine.disease Embolization Therapeutic Magnetic Resonance Imaging Cerebral Angiography Surgery Causality Treatment Outcome Neurology Neurology (clinical) Pseudoefedrina Intracranial Hypertension Tomography X-Ray Computed business |
| Zdroj: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 32:248-252 |
| ISSN: | 2057-0155 0317-1671 |
| DOI: | 10.1017/s0317167100004066 |
| Popis: | Background:Sympathomimetic-related intracerebral hemorrhage is well-documented. Most cases are associated with phenylpropanolamine use.Case Report:We report a case of intracerebral hemorrhage occurring in a middle-aged man who suffered from chronic sinusitis and had been ingesting pseudoephedrine daily for one year. This patient was previously well with no known cardiovascular risk factors. Clinical examination revealed no evidence of vasculitis nor coagulopathy and initial neuroimaging (i.e., computed tomography, angiography, magnetic resonance imaging) demonstrated no features consistent with aneurysm, arteriovenous malformation (AVM), cavernoma, nor cerebral metastases. A follow-up cerebral angiogram demonstrated a small AVM arising off a branch of the pericallosal artery and a small arteriovenous fistula arising off the costal marginal branch. The AVM was embolized without incident, however, the AVF was not accessible.Conclusions:Sympathomimetics have long been associated with intracerebral hemorrhage. Since 1979, over 30 published case reports have documented the relationship between phenylpropanolamine and stroke. Only one report links phenylpropanolamine consumption to an intracerebral hemorrhage in a patient with an AVM. There is a paucity of literature etiologically inculpating other ephedra alkaloids in the causation of intracerebral hemorrhage. This is a case of pseudoephedrine-induced intracerebral hemorrhage in a patient with an underlying vascular malformation. |
| Databáze: | OpenAIRE |
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