A man in Australia had a very rare case wherein his dentist trip triggered brain bleeding and resulted in a rare genetic disorder diagnosis.
Brain Bleeding Following Standard Dental Procedure
The man, over 60 years old, experienced dizziness and started vomiting roughly thirty minutes after having two tooth extractions. His vision also ended up being disrupted to the point where he viewed objects that rotated counterclockwise by 90 degrees.
He was then rushed to the emergency room, where specialists discovered that he had elevated blood pressure and his eyes flickered toward the left. On top of this, he also had a wonky gait and a right-leaning posture. This made it apparent that something was not right in neurological terms.
ICH and CADASIL
While the link between the standard dental procedure and brain bleeding cannot be conclusively established, the study authors, who documented the case in a recent study, think that the sharp blood pressure rise could have triggered intracerebral hemorrhage (ICH). A computed tomography (CT) scan showed that his brain's lower left half was bleeding, as stroke is one of the first conditions that should be ruled out in these cases.
The patient was also suspected of having Parkinson's disease and had to take a simple CT scan six weeks before this occurred. In terms of blood vessels, there were no clear alarming signs. However, there were signs of white matter disease, which broadly refers to damage in the white cells of the brain that is brought about by blood flow reductions.
MRI scans revealed a more in-depth look into the case and told that the patient was dealing with a more intense chronic pathology. The case report's authors looked into the man's DNA and discovered that he had a mutation in the NOTCH3 gene, which is linked to a rare genetic condition that leads to the thickening of blood vessel walls. This condition is called CADASIL, which stands for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.
Severe CADASIL cases only statistically affect two people in every 100,000. Hence, the condition is typically hard to diagnose. Common symptoms include weakness, visual problems, and struggles with walking. It tends to resemble other neurological illnesses, like multiple sclerosis.
The authors note that ICH was first considered a rare CADASIL complication. However, studies show that it could be more common than thought. Nevertheless, regardless of the frequency of the link between the two conditions, this is the first case wherein ICH was reported in a CADASIL patient after a standard dental procedure.
After this visit to the emergency department, the man was prescribed blood pressure medications. After three months, the man reportedly improved in unsteadiness, and his vision returned to normal. He has been prescribed chronic aspirin treatment to prevent further strokes and improve brain blood flow.
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