Department of Neurology, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Acta Neurol Belg. 2024 Aug;124(4):1353-1356. doi: 10.1007/s13760-024-02573-2. Epub 2024 May 18.
Spinal cord infarction is a rare condition, accounting for only a small percentage of strokes. It can be classified into cervical and thoracolumbar infarctions, with various factors contributing to its occurrence. Sildenafil, a phosphodiesterase type 5 inhibitor commonly used for erectile dysfunction, has been associated with cardiovascular side effects, including transient hypotension. In this case report, we present the unusual occurrence of spinal cord infarction in a 65-year-old man who had self-administered high doses of sildenafil without a doctor's prescription. The patient experienced severe radicular pain in the lumbar region and subsequent weakness in the lower limbs. Evaluation revealed an anterior spinal cord infarction in the thoracic region, confirmed by MRI imaging. After excluding other potential causes, it was concluded that the intake of sildenafil likely led to systemic hypotension, resulting in spinal cord infarction. This case highlights the importance of considering sildenafil as a possible contributor to spinal cord infarction, particularly when used at high doses. Further studies are needed to better understand the relationship between sildenafil and vascular complications, including spinal cord infarction.
脊髓梗死是一种罕见的疾病,仅占中风的一小部分。它可以分为颈段和胸腰段梗死,有多种因素导致其发生。西地那非是一种常用于治疗勃起功能障碍的磷酸二酯酶 5 抑制剂,与心血管副作用有关,包括短暂性低血压。在本病例报告中,我们介绍了一位 65 岁男性患者自行服用大剂量西地那非(未遵医嘱)后发生不常见的脊髓梗死。该患者出现严重的腰骶神经根痛,随后下肢无力。评估发现胸段脊髓前动脉梗死,MRI 成像证实了这一诊断。排除其他潜在病因后,认为西地那非的摄入可能导致全身低血压,进而引发脊髓梗死。本病例强调了将西地那非视为脊髓梗死的一个可能病因的重要性,尤其是在高剂量使用时。需要进一步研究以更好地了解西地那非与血管并发症(包括脊髓梗死)之间的关系。