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Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra) use.

Kim KK, Kim DG, Ku YH, Lee YJ, Kim WC, Kim OJ, Kim HS

Department of Neurology, Pochon CHA University College of Medicine, Seongnam-si, Gyeunggi-do, South Korea.

Sildenafil citrate (Viagra) is one of the frequently prescribed drugs for men with erectile dysfunction. We describe a 52-year-old man with bilateral middle cerebral artery (MCA) territory infarction after sildenafil use. He ingested 100 mg of sildenafil and about 1 h later, he complained of chest discomfort, palpitation and dizziness followed by mental obtundation, global aphasia and left hemiparesis. Brain magnetic resonance imaging documented acute bilateral hemispheric infarction, and cerebral angiography showed occluded bilateral MCA. Despite significant bilateral MCA stenosis and cerebral infarction, systemic hypotension persisted for a day. We presume that cerebral infarction was caused by cardioembolism with sildenafil use.

Published 22 February 2008 in Eur J Neurol, 15(3): 306-8.
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