Sildenafil is a selective phosphodiesterase-5 enzyme inhibitor. With the inhibition of PDE-5, the amount of cyclic-guanosine monophosphate (c-GMP) in the smooth vascular muscle cells in the corpus cavernosum increases, leading to a relaxation of muscles and vasodilatation. Studies have shown that the NO-c-GMP pathway leads to cerebral vasodilatation with a similar mechanism. The literature has shown that the effect of PDE-1 and PDE-2 on cerebral bleeding control is affected by sildenafil. This increased blood flow increases the risk of intracranial haemorrhage.
Although data concerning the presentation of intracerebral hematoma in connection with the combined use of alcohol ingestion and use of sildenafil is inadequate, it can nevertheless be thought that the combined use increases the risk of spontaneous intracerebral hemorrhage and caution is in order concerning the matter.
Keywords : Sildenafil, Intracerebral, Hemorrhage, Alcohol, Subarachnoid bleeding