Department of Neurology, Bozyaka Training and Research Hospital, Izmir, Turkey.
Department of Ophthalmology, Bozyaka Training and Research Hospital, Saim Cıkrıkcı Cad. No: 59, Bozyaka, Izmir, Turkey.
Neurol Sci. 2017 Sep;38(9):1727-1729. doi: 10.1007/s10072-017-2987-5. Epub 2017 May 4.
We present a rare case of cerebral venous sinus thrombosis associated with long-term and high-dose use of sildenafil. A 29-year-old man was referred to our neuroophthalmology clinic for bilateral visual deterioration and severe headache. He had stage 2 papilledema and other clinical and neurological examinations were normal. He had used the drug for nearly 2 years, two to three times a day. All laboratory parameters including blood count cell, coagulation panels, and genetic tests including methylene-tetrahydrofolate reductase and factor V Leiden mutation were unremarkable. The brain magnetic resonance imaging result confirmed transverse cerebral venous sinus thrombosis (CVST). The opening pressure of cerebrospinal fluid (CSF) was 43 cm HO with normal biochemistry and no cells. Clinicians must be aware of the possibility of CVST when the patient uses sildenafil.
我们报告一例罕见的与长期大剂量使用西地那非相关的脑静脉窦血栓形成。一名 29 岁男性因双侧视力下降和严重头痛被转至我们的神经眼科诊所。他有 2 级视盘水肿，其他临床和神经系统检查均正常。他使用该药物已有近 2 年时间，每天 2 至 3 次。包括全血细胞计数、凝血谱以及亚甲基四氢叶酸还原酶和因子 V Leiden 突变在内的所有实验室参数均无明显异常。脑部磁共振成像结果证实为横窦脑静脉窦血栓形成（CVST）。脑脊液（CSF）的压力为 43cmH2O，CSF 生化正常且无细胞。当患者使用西地那非时，临床医生必须意识到发生 CVST 的可能性。
