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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886
EISSN: 0028-3886
Vol. 56, No. 1, 2008, pp. 88-89
Bioline Code: ni08022
Full paper language: English
Document type: Case Report
Document available free of charge

Neurology India, Vol. 56, No. 1, 2008, pp. 88-89

 en Acute progressive midbrain hemorrhage after topical ocular cyclopentolate administration
Calisaneller, Tarkan; Ozdemir, Ozgur; Sonmez, Erkin & Altinors, Nur


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.

Cyclopentolate, midbrain hemorrhage, systemic anticholinergic toxicity

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