Acute progressive midbrain hemorrhage after topical ocular cyclopentolate administration.
Cyclopentolate is a synthetic anti-cholinergic agent widely used in ophthalmology clinics. It can cause cardiovascular side-effects such as hypertension, ventricular arrhythmias and tachycardias. A 55-year-old male lost his consciousness after topical cyclopentolate hydrocloride (1%) administration for routine fundoscopic examination in another center. An urgent cranial magnetic resonance imaging examination revealed a midbrain hemorrhage and he was transferred to our hospital. The Glasgow Coma Scale score was at 4 points at admission. The patient was transferred to the intensive care unit and mechanically ventilated. Despite vigorous medical treatment, spontaneous respiration and brainstem reflexes disappeared 12 h after his administration. A control cranial computerized tomography showed enlargement and opening of the hemorrhage into the ventricular system. The patient died on the 12th day of his administration. Systemic side-effects of topical ocular cyclopentolate administration and prevention methods were discussed with regard to the current literature.
Calisaneller
Tarkan
T
Department of Neurosurgery, Baskent University Faculty of Medicine, Ankara, Turkey. tarkan_ca@yahoo.com
Ozdemir
Ozgur
O
Sonmez
Erkin
E
Altinors
Nur
N
D003519:Cyclopentolate / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology* / Q000532:radiotherapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed / Q000379:methods
D018727:Muscarinic Antagonists; D003519:Cyclopentolate