Vertebral artery dissection associated with sildenafil abuse

Area of Science:

• Neurology
• Cardiovascular Medicine
• Pharmacology

Background:

• Vertebral artery dissection can lead to ischemic stroke, particularly cerebellar infarction.
• Sildenafil is a phosphodiesterase type 5 inhibitor commonly used for erectile dysfunction and sexual enhancement.
• Previous reports have suggested a possible association between sildenafil and aortic dissection.

Observation:

• A 49-year-old male presented with cerebellar infarction secondary to vertebral artery dissection.
• The patient reported consistent daily use of sildenafil for at least two years for sexual enhancement.
• No recent sexual activity or preceding trauma was reported prior to symptom onset.

Findings:

• This case highlights a potential association between chronic, daily sildenafil use and arterial dissection.
• The patient's presentation suggests that sildenafil, even without recent sexual activity or trauma, may be implicated in arterial dissection events.
• The findings warrant further investigation into the potential risk factors associated with long-term sildenafil consumption.

Implications:

• Chronic sildenafil intake may represent an underrecognized risk factor for arterial dissection.
• Clinicians should consider medication history, including long-term sildenafil use, in patients presenting with arterial dissection.
• Further research is needed to elucidate the mechanisms and confirm the causal relationship between chronic sildenafil use and arterial dissection risk.