-Ten percent of all strokes are due to spontaneous cerebral hemorrhages. They are associated to drugs (licit and illicit) in 9.5% of all cases in young adults. This is a case report of a 44-year-old man, without previous morbidities, who presented a sudden onset headache and arterial hypertension 24 hours after use of naphazoline as nasal decongestant. Cranial tomography showed right thalamus hemorrhage. Cerebral angiography showed no aneurisms, vascular malformations or vasculitis. No other risk factors were found during investigation in this patient and the stroke was attributed to naphazoline exposition.KEY WORDS: hemorrhagic stroke, naphazoline, sympathomimetic drug.Acidente vascular encefálico hemorrágico após exposição à nafazolina: relato de caso RESUMO -Dez por cento de todos os eventos vasculares encefálicos são devido às hemorragias intracerebrais espontâneas, associados a drogas (lícitas e ilícitas) em 9,5% de todos os casos em adultos jovens. Relatamos o caso de um homem de 44 anos de idade, sem doenças prévias, que apresentou cefaléia súbita e hipertensão arterial 24 horas após o uso de congestionante nasal contendo nafazolina. A tomografia de crânio evidenciou hemorragia talâmica. Durante a investigação não foram encontrados outros fatores de risco e a hemorragia foi atribuída à exposição à nafazolina. PALAVRAS-CHAVE: doença vascular encefálica hemorrágica, nafazolina, droga simpaticomimética.Cerebrovascular diseases occur more frequently in elderly people. Peak incidence is between 7 th and 8 th decades 1,2 . Before age 55, incidence is 10% 3,4 and before 45 it falls to 3.9% 5 .Ten percent of all cerebrovascular events are due to hemorrhage 6 . Its estimated incidence in United States of America is 0.3/100000 in younger than 35 years old 7 . Main etiologies are vascular malformations, arterial hypertension and exposition to drugs (amphetamines, sympathomimetics and illicit drugs) 8,9 . In young adults, drugs are associated to 9.5% of ischemic and hemorrhagic stroke 10 .We report a case of exposition to sympathomimetic drug naphazoline followed by thalamic hemorrhage.
CASEA 44 year-old previously healthy man, with no history of arterial hypertension, was admitted to the emergency department of Hospital de Clinicas, Federal University of Parana, complaining of headache and left arm weakness. Five days before he had had some flu-like symptoms and naphazoline nasal decongestant was prescribed. In the following day he had a sudden onset headache associated to nausea and vomiting. He then looked for medical attention. Blood pressure was 190/120 mmHg and captopril 50 mg as a single dose was prescribed. A couple of days latter he developed left hemiparesia that made him seek for our emergency department. There was no previous history of thrombotic disorders and there were no familiar stroke cases.On physical examination vital signs were normal including blood pressure (120/70 mmHg), with no positive signs on cardiopulmonary and abdominal examination. Neurological examination revealed an oriented ...