Sildenafil Use and Cigarette Smoking Associated with Intracerebral Hemorrhage: A Rare Case Report

M. Hassan, I. Mohamed, A. Omar, Zakaria Adan, Bashiru Garba, Omar Badawi
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Abstract

Background Intracerebral hemorrhage (ICH) is a serious condition characterized by bleeding within the brain tissue. Although the use of sildenafil, a vasodilator agent for erectile dysfunction, has been associated with rare cases of ICH, the combination of sildenafil usage and smoking as risk factors for ICH has not yet been reported. This case report describes the occurrence of ICH in a patient with a history of both sildenafil usage and heavy smoking. Case Presentation A 53-year-old male, with a history of smoking and regular sildenafil use, was brought to the emergency department due to loss of consciousness with right-side weakness, he initially experienced with nausea, vomiting and dizziness after taking sildenafil 100mg tablet once. The Glasgow Coma Score (GCS) was 10 with side hemiparesis. Non-contrast CT revealed left thalamic acute hemorrhage with ventricular extension. Furthermore, a head CT angiography ruled out any vascular anomalies after that the patient was admitted to the intensive care unit (ICU) for conservative management. After three days on clinical and neurological improvement, the patient was transferred to the inpatient ward for further management, monitoring and physiotherapy. On day 6, the patient was discharged and planned for flow up. Conclusion This rare case highlights the need for further research and awareness regarding the potential risks associated with the combination of sildenafil and heavy smoking. Healthcare professionals should carefully evaluate the individual risk factors of patients, educate them about potential complications, and consider alternative treatments if necessary. Additionally, patients should be encouraged to quit smoking and adopt a healthy lifestyle to minimize the risk of cerebrovascular events.
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使用西地那非和吸烟导致脑出血:罕见病例报告
背景 大脑内出血(ICH)是一种以脑组织内出血为特征的严重疾病。虽然西地那非(一种治疗勃起功能障碍的血管扩张剂)的使用与罕见的 ICH 病例有关,但将西地那非的使用和吸烟同时作为 ICH 的危险因素尚未见报道。本病例报告描述了一名既服用过西地那非又有大量吸烟史的患者发生 ICH 的情况。病例介绍 一位 53 岁的男性患者,有吸烟史并经常服用西地那非,因意识丧失伴右侧肢体无力被送至急诊科。格拉斯哥昏迷评分(GCS)为10分,伴有一侧偏瘫。非对比 CT 显示左侧丘脑急性出血并伴有脑室扩展。此外,头部 CT 血管造影排除了任何血管异常,随后患者被送入重症监护室(ICU)接受保守治疗。三天后,患者的临床和神经功能有所改善,被转到住院病房接受进一步的管理、监测和理疗。第 6 天,患者出院并计划接受进一步治疗。结论 这一罕见病例凸显了进一步研究和认识西地那非与大量吸烟联合使用的潜在风险的必要性。医护人员应仔细评估患者的个体风险因素,向他们讲解潜在的并发症,并在必要时考虑其他治疗方法。此外,应鼓励患者戒烟并采取健康的生活方式,以最大限度地降低脑血管事件的风险。
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