sildenafil-citrate and Cerebral-Hemorrhage

Sildenafil is a drug used in the treatment of male impotence. Few cases of spontaneous intracerebral hemorrhage following the use of sildenafil have been cited in the literature. A 42-year-old man was admitted to the emergency outpatient clinic of İstanbul Educational and Research Hospital after sudden loss of consciousness. He had ingested alcohol, taken 50mg sildenafil and had sexual intercourse. Non-contrast cranial tomography revealed an intracerebral hematoma with extension to the ventricles. Sildenafil is a selective phosphodiesterase-5 enzyme inhibitor. With the inhibition of PDE-5, the amount of cyclic-guanosine monophosphate (c-GMP) in the smooth vascular muscle cells in the corpus cavernosum increases, leading to a relaxation of muscles and vasodilatation. Studies have shown that the NO-c-GMP pathway leads to cerebral vasodilatation with a similar mechanism. The literature has shown that the effect of PDE-1 and PDE-2 on cerebral bleeding control is affected by sildenafil. This increased blood flow increases the risk of intracranial haemorrhage. Although data concerning the presentation of intracerebral hematoma in connection with the combined use of alcohol ingestion and use of sildenafil is inadequate, it can nevertheless be thought that the combined use increases the risk of spontaneous intracerebral hemorrhage and caution is in order concerning the matter.

Topics: Adult; Central Nervous System Depressants; Cerebral Hemorrhage; Ethanol; Humans; Illicit Drugs; Male; Phosphodiesterase 5 Inhibitors; Sildenafil Citrate; Subarachnoid Hemorrhage

Topics: Adult; Cerebral Hemorrhage; Humans; Male; Phosphodiesterase 5 Inhibitors; Piperazines; Purines; Sildenafil Citrate; Sulfones

A case of cerebral hemorrhage associated with sildenafil (Revatio) use in an infant is presented. Sildenafil is increasingly used in the treatment of primary and secondary pulmonary arterial hypertension and pulmonary arteriovenous fistula. In the reported case, sildenafil used to treat pulmonary arteriovenous fistula improved right-to-left shunting across the pulmonary fistula but resulted in cerebral hemorrhage. Cerebral hemorrhage, a previously reported complication of sildenafil, developed in an infant after a rapid increase in dose, to 4.7 mg/kg/day. Therefore, sildenafil doses must be increased only with care, and cerebral hemorrhage must be considered a potential complication.

Topics: Arteriovenous Fistula; Cerebral Hemorrhage; Diagnosis, Differential; Female; Humans; Infant; Phosphodiesterase Inhibitors; Piperazines; Pulmonary Artery; Pulmonary Veins; Purines; Sildenafil Citrate; Sulfones

Topics: Cerebral Arteries; Cerebral Hemorrhage; Cyclic GMP; Cyclic Nucleotide Phosphodiesterases, Type 5; Humans; Hypertension; Internal Capsule; Magnetic Resonance Imaging; Male; Middle Aged; Paresis; Phosphodiesterase 5 Inhibitors; Phosphodiesterase Inhibitors; Piperazines; Purines; Recovery of Function; Sildenafil Citrate; Sulfones; Thalamus; Tomography, X-Ray Computed; Vasodilation; Vasodilator Agents

Topics: Cerebral Hemorrhage; Cerebrovascular Circulation; Coitus; Dyskinesias; Humans; Hypertension; Male; Middle Aged; Piperazines; Purines; Sildenafil Citrate; Subthalamic Nucleus; Sulfones; Thalamic Nuclei; Tomography, X-Ray Computed

Topics: Aged; Brain; Cerebral Hemorrhage; Erectile Dysfunction; Humans; Magnetic Resonance Imaging; Male; Phosphodiesterase Inhibitors; Piperazines; Purines; Sildenafil Citrate; Sulfones

Sildenafil (Viagra) has been developed as a drug to help male impotence. It has a direct effect on the vasculature of the corpus cavernosum. A case of spontaneous intracerebral haemorrhage (ICH) following the illicit use of Viagra is reported. A discussion of drug-induced ICH is included.

Topics: Adult; Cerebral Hemorrhage; Drug Overdose; Fatal Outcome; Humans; Male; Phosphodiesterase Inhibitors; Piperazines; Purines; Sildenafil Citrate; Sulfones; Tomography, X-Ray Computed