An Australian man in his 60s was rushed to the emergency room complaining of nausea, dizziness and slanted eyes after a simple tooth extraction, and was later diagnosed with a rare disease that causes blood vessels in the brain to shrink.
Although it is impossible to say with certainty that there is a link between bleeding and dental procedures, the authors of one paper Recently published case studies They suspect that a sudden rise in blood pressure may have triggered what is known in medical terms as an “extraordinary event.” intracerebral hemorrhage.
Even while in the emergency room, the patient’s blood pressure remained understandably high. It was clear to the neurologist that something was wrong, as his eyes darted to the left, his gait was unsteady, and his posture tilted heavily to the right.
One of the first diagnoses to rule out in such cases is stroke. An emergency CT scan quickly revealed a small hemorrhage pressing against tissue in the lower left half of the patient’s brain.
Because it is such an important organ, the blood vessels that supply the brain are not prone to leaking on their own. In fact, they are well adapted to keep all but the most important substances away from sensitive neurons and their supporting cells.
Therefore, identifying the cause of intracerebral hemorrhage becomes a top priority. Parkinson’s disease was recently suspected, but the patient had a simple illness. CT scan This photo was taken exactly 6 weeks ago.
There were no obvious signs of concern as far as blood vessels were concerned, but there were some signs. white matter disease – Extensive reference to damage to the “white blood cells” that support the brain caused by reduced blood flow.
The medical team used MRI to get a more detailed look and map the areas and types of brain tissue affected. Again, focal areas of white matter disease suggested deeper, more chronic pathology.
acronym kadasil – The case of autosomal dominant cerebral arteriopathy with subcortical infarcts and leukoencephalopathy – describes a rare pathology that affects blood flow through small blood vessels, especially those that thread the brain substance.
The impact is thought to be small. 2 in 100,000 peoplethis condition is usually overlooked or misdiagnosed, so it’s difficult to know exactly how common it is.
Thanks to a mutated gene that codes for a special receptor protein, the muscles surrounding the blood vessels die prematurely, weakening the capillaries until they become occluded. The end result is typically leukoencephalopathy, the death of the white matter in the brain.
1 DNA test in case of fracture notch 3 The gene was then detected and the patient received a diagnosis. Over the next few months, he recovered from the bleeding, but was given long-term aspirin to keep his blood flowing, as well as medication to control his blood pressure.
Although occlusion may be common in patients with CADASIL, bleeding is less common, at least when compared to other abnormalities that cause stroke. In fact, this case study is the first to report cerebral hemorrhage in a dental patient using CADASIL.
There are only three other cases in the medical literature of people who experienced bleeding in the brain while sitting in the dentist’s chair. 1 A report from more than 30 years ago featured a 52-year-old woman who suffered from a painful abscess, but unfortunately suffered a significant intracerebral hemorrhage and did not survive.
Before you use these rare cases of neurological trauma as an excuse to avoid your next checkup, it’s important to remember that your dentist is your brain’s best friend.
Having periodontal disease for many years can increase your risk of Alzheimer’s disease by as much as 70%. Similarly, poor oral hygiene can cause areas of the brain associated with memory to shrink.
Calm down and say, “Ah.” There’s a good chance you’ll still be smiling for decades to come.
This study BMJ case report.
A version of this article was first published in August 2023.