Metoclopramide-induced raised intracranial pressure after head injury.
We report a case of raised intracranial pressure in a head-injured patient following the intravenous administration of metoclopramide. The patient required admission to an intensive care unit after a road traffic accident. A CT scan of the head was consistent with diffuse axonal injury and supportive management included intracranial pressure monitoring. On the third day after admission, intravenous metoclopramide 10mg was administered to aid gastric emptying during nasogastric feeding. Intracranial pressure increased to 39mmHg from a baseline of 15-20mmHg. The same dose of metoclopramide was repeated the next day during transcranial doppler studies with an increase in ICP to 34mmHg and an associated rise in middle cerebral artery systolic blood velocity from 122cms-1 to 150cms-1. This effect of metoclopramide has not been previously reported.
Deehan
Simon
S
Intensive Care Unit, Royal Perth Hospital, Perth, Australia.
Dobb
Geoffrey J
GJ
D000063:Accidents, Traffic; D000328:Adult; D000932:Antiemetics / Q000009:adverse effects*; D002560:Cerebrovascular Circulation / Q000502:physiology; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects*; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects*; D016343:Monitoring, Intraoperative; D017585:Ultrasonography, Doppler, Transcranial
D000932:Antiemetics; D008787:Metoclopramide