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Moyamoya disease in which pentazocine treatment caused cerebral infarction

Yoshinori Matsuoka1, Makoto Hashizume

  • 1Department of Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Kyushu, Japan. yoshinori216@h2.dion.ne.jp

BMJ Case Reports
|July 14, 2012
PubMed

Insights

A young man

Area of Science:

  • Neurology
  • Vascular Neurology
  • Radiology

Background:

  • A 37-year-old male presented with perineal trauma and scrotal hematoma.
  • Patient experienced a decline in consciousness following pentazocine injections.

Observation:

  • Cerebral infarction was suspected due to CT findings of low signals in the left putamen, frontal lobe, and corticomedullary junction.
  • MR angiography revealed bilateral middle cerebral artery obstruction, leading to a diagnosis of moyamoya disease.

Findings:

  • Medical treatment with edaravone, argatroban, and heparin failed to restore blood flow in the middle cerebral arteries.
  • The patient suffered severe adverse effects.

Implications:

  • Cerebrovascular accident should be considered in young patients with altered consciousness, especially after drug administration affecting brain circulation.
  • Moyamoya disease diagnosis requires suspicion based on history and confirmation via MR angiography for timely intervention.
  • Early diagnosis and re-establishment of blood circulation are crucial for managing moyamoya disease and preventing severe outcomes.

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