Sildenafil (Viagra) and a Rare Complication: Intracerebral Hemorrhage

Abstract

Sildenafil is fist efective oral agent in treatment of erectil dysfunction. It relaxes the smooth muscles of the corpus cavernosum selectively by inhibiting phosphodiesterase type 5 and causes potential erection during sexual stimulation. Although its low dose is efective, the most effective dose is 50-100 mg. The use of sildenafil is associated with various complications. Using high-dose sildenafil in especially groups with risk may cause mortal complications. It reduces transiently the blood pressure. If it is used associated with nitrates, it may cause severe hipotension. The most frequent reported complications are headache, flushing, nasal kongestion, dispepsi and vision disorder. With painful and long-term erections are frequent seen. The side effects are transient. A 45 - year - old man was admitted to our hospital because of intraventricle hemorrhage after sildenafil use. To our knowledge, this rare complication related to sildenafil has never been reporded until now. Chronic sildenafil use causes disorder in the endotel layer of the vessel, also high dose sildenafil lead to vasodiladation extensively. Therefore, we believe that extensive vasodilatation due to high dose sildenafil in the defeated vessels causes rupture of cerebral arteries. Also undiagnosed cerebrovascular disease such as aneurysm, arteriovenous malformation, cavernous angioma may cause brain bleeding extensive excersize during sexual performance.