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Aspirin, Hyperventilation, and Cerebellar Infarction in Sickle Cell Disease

Aspirin, Hyperventilation, and Cerebellar Infarction in Sickle Cell Disease Abstract Aspirin ingestion was followed by hyperventilation, cerebellar signs, and fatal brain stem dysfunction in a patient with sickle cell disease. Autopsy showed a swollen, recently infarcted cerebellum with tonsillar herniation compressing the medulla. We propose that hypocapnea from aspirin-induced hyperventilation caused carotid artery constriction and focal cerebral hypoxia, resulting in cerebellar sickling and infarction. Hypocapnea should be treated promptly to prevent brain damage in patients with sickle cell disease. (Arch Intern Med 138:148-149, 1978) References 1. Portnoy BA, Herion JC: Neurological manifestations in sickle-cell disease . Ann Intern Med 76:643-652, 1972.Crossref 2. Greer M, Schotland D: Abnormal hemoglobin as a cause of neurologic disease . Neurology 12:114-123, 1962.Crossref 3. Baird RL, Weiss DL, Ferguson AD, et al: Studies in sickle cell anemia: XXI. Clinico-pathological aspects of neurological manifestations . Pediatrics 34:92-100, 1964. 4. Paterson JCS, Spragus CC: Observation on the genesis of crises in sickle cell anemia . Ann Intern Med 50:1502-1507, 1959.Crossref 5. Protass LM: Possible precipitation of cerebral thrombosis in sickle-cell anemia by hyperventilation . Ann Intern Med 79:451, 1973.Crossref 6. Lehrich JR, Winkler GF, Ojemann RG: Cerebellar infarction with brain stem compression: Diagnosis and surgical treatment . Arch Neurol 22:490-498, 1970.Crossref 7. Sypert GW, Ellsworth CA Jr: Cerebellar infarction: A clinicopathological study . Arch Neurol 32:357-363, 1975.Crossref 8. Gotoh F, Meyer JS, Takagi Y: Cerebral effects of hyperventilation in man . Arch Neurol 12:410-423, 1965.Crossref 9. Klotz IM, Tam JWO: Acetylation of sickle cell hemoglobin by aspirin . Proc Natl Acad Sci USA 70:1313-1315, 1973.Crossref 10. Hill JB: Current concepts: Salicylate intoxication . N Engl J Med 288:1110-1113, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Aspirin, Hyperventilation, and Cerebellar Infarction in Sickle Cell Disease

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1978.03630250102028
Publisher site
See Article on Publisher Site

Abstract

Abstract Aspirin ingestion was followed by hyperventilation, cerebellar signs, and fatal brain stem dysfunction in a patient with sickle cell disease. Autopsy showed a swollen, recently infarcted cerebellum with tonsillar herniation compressing the medulla. We propose that hypocapnea from aspirin-induced hyperventilation caused carotid artery constriction and focal cerebral hypoxia, resulting in cerebellar sickling and infarction. Hypocapnea should be treated promptly to prevent brain damage in patients with sickle cell disease. (Arch Intern Med 138:148-149, 1978) References 1. Portnoy BA, Herion JC: Neurological manifestations in sickle-cell disease . Ann Intern Med 76:643-652, 1972.Crossref 2. Greer M, Schotland D: Abnormal hemoglobin as a cause of neurologic disease . Neurology 12:114-123, 1962.Crossref 3. Baird RL, Weiss DL, Ferguson AD, et al: Studies in sickle cell anemia: XXI. Clinico-pathological aspects of neurological manifestations . Pediatrics 34:92-100, 1964. 4. Paterson JCS, Spragus CC: Observation on the genesis of crises in sickle cell anemia . Ann Intern Med 50:1502-1507, 1959.Crossref 5. Protass LM: Possible precipitation of cerebral thrombosis in sickle-cell anemia by hyperventilation . Ann Intern Med 79:451, 1973.Crossref 6. Lehrich JR, Winkler GF, Ojemann RG: Cerebellar infarction with brain stem compression: Diagnosis and surgical treatment . Arch Neurol 22:490-498, 1970.Crossref 7. Sypert GW, Ellsworth CA Jr: Cerebellar infarction: A clinicopathological study . Arch Neurol 32:357-363, 1975.Crossref 8. Gotoh F, Meyer JS, Takagi Y: Cerebral effects of hyperventilation in man . Arch Neurol 12:410-423, 1965.Crossref 9. Klotz IM, Tam JWO: Acetylation of sickle cell hemoglobin by aspirin . Proc Natl Acad Sci USA 70:1313-1315, 1973.Crossref 10. Hill JB: Current concepts: Salicylate intoxication . N Engl J Med 288:1110-1113, 1973.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1978

References