Sildenafil
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Stroke: case report A 61-year-old man experienced multiple strokes during treatment with sildenafil for erectile dysfunction. The man presented with vertigo and hearing loss of his right ear, with articulation speech difficulties. On examination, bilateral, coarse, horizontal nystagmus was observed and the fast component was more pronounced on his right. He was unable to stay upright, even when sitting, and could only take 3–4 steps when assisted by two people. Seven months before presentation, he received sildenafil 50mg and had then experienced vertigo even before sexual intercourse was attempted and, 3 months later, he received sildenafil 50mg again and experienced severe vertigo with gait disturbance, nausea and vomiting, which resolved spontaneously in a few days. It was discovered that his symptoms were preceded by receiving sildenafil 2 hours earlier, and that his presenting complaints were also preceded by taking sildenafil [time to reaction onset not clearly stated]. He was hospitalised and a brain MRI showed several round lesions, which were hyperintense and hypointense in T2 and T1-weighted images, respectively, located in the right cerebellar peduncle; several smaller lesions were observed in his pons, left cerebellar peduncle and both cerebellar hemispheres. Following gadolinium application, the lesions in the left peduncle were enhanced. Magnetic resonance angiography showed right posterior cerebral artery hypertrophy, and vertebral and basilar artery narrowing. After a 1-year follow-up, he showed good recovery, had not taken sildenafil and had no more stroke episodes. [Patient treatment not stated]. Author comment: "We report a patient with multiple strokes in the posterior cerebral circulation in close temporal association with sildenafil use." Habek M, et al. Stroke - an adverse reaction to sildenafil. Clinical Neuropharmacology 29: 165-167, No. 3, May-Jun 2006 - Croatia
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0114-9954/10/1109-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 8 Jul 2006 No. 1109
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