Reactions Weekly | 2021
Sertraline
Abstract
Reversible cerebral vasoconstriction syndrome: case report A 23-year-old woman developed reversible cerebral vasoconstriction syndrome secondary to sertraline for anxiety disorder. The woman ingested sertraline 150mg for anxiety disorder due to missing anxiety disorder treatment for 30 days. Six hour later, she presented to emergency department with global aphasia, right and complete hemiparesis and low level of consciousness. NIH Stroke Scale score was noted to be 15. Twelve days previously, she underwent resection of a large fronto-temporo-esphenoidal meningioma that led to vasoconstriction. Brain CT scan showed cortical-subcortical hypodensity on the parasagittal segment of the left frontal lobe projecting to the ipsilateral cingulate gyrus, superior frontal gyrus and corpus callosum with thinning of the distal segment of the intern carotid artery and the M1 segment medial cerebral artery, which was worse than the previous vascular study. Digital angiographic study showed vasospasm of the affected artery. The woman was treated with milrinone. Significant reduction of vasospasm of the anterior and middle cerebral artery and complete resolution of the symptoms were noted. NIH Stroke Scale score was noted to be 0. She was admitted to the ICU. She underwent more diagnostic tests and complementary therapeutic milrinone and verapamil with suspicion of reversible cerebral vasoconstriction syndrome [duration of treatment to reaction onset not stated].