Simvastatin
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Worsening of cerebrovascular reserve in an elderly patient: case report A 66-year-old man experienced worsening of cerebrovascular reserve while receiving simvastatin. The man started receiving simvastatin [dosage and route not stated] and aspirin for right middle cerebral artery infarct, diagnosed 6 months after surgery and radiation for glioblastoma multiforme. A baseline transcranial Doppler (TCD) showed flow diversion in the right hemisphere suggesting distal stenosis. His breath holding index (BHI) was 0.42. The man’s simvastatin therapy was withdrawn [duration of therapy not stated]. TCD at a 6-week followup showed persistent flow diversion, although his BHI had improved to 0.78. Data indicated poor haemodynamic flow to the right hemisphere, resulting from small arteriolar disease from radiation vasculopathy. Simvastatin appeared to worsen the haemodynamic flow to the affected hemisphere. Author comment: "In the special circumstance of a patient with isolated high-grade cerebrovascular disease in a single vascular bed, the addition of a statin may lead to a cerebral steal phenomenon." Volpi JJ, et al. Withdraw of statin improves cerebrovascular reserve in radiation vasculopathy. Perspectives in Medicine 1: 309-310, No. 1-12, Sep 2012. Available 803081086 from: URL: http://dx.doi.org/10.1016/j.permed.2012.02.020 - USA
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Reactions 15 Dec 2012 No. 1432
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