Abstract:

İntroduction: Sildenafil is a phosphodiesterase 5 enzyme inhibitor used in the treatment of erectile dysfunction and pulmonary hypertension. The use of sildenafil with nitrates is well known to cause myocardial ischemia. However, patients with a history of hypotension, arrhythmia, previous myocardial infarction, or stroke should be given sildenafil carefully. A few cases have been reported in the literature related to ischemic stroke and transient ischemic attack due to sildenafil use. Case report: We report a case of middle cerebral artery (MCA) infarction after two tablets sildenafil in a 57-year-old male patient with no underlying disease. In the diffusion MRI (magnetic resonance imaging) imaging of the patient, acute diffusion limitation was observed in the left frontal lobe and parietal lobe starting from the centrum semiovale level and also in the MCA supply area affecting the medial section of the temporal lobe. We believe that this infarction is caused by the development of severe hypotension due to alcohol use with sildenafil. Conclusion: Not only availability of hypotension, history of MI and stroke, health care providers should also give attention prescribing sildenafil in the case of cigarette and alcohol use.

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