Perfusion-Dependent Focal Neurologic Deficits in a Critically Ill Heart Transplant Recipient: A Case of Tacrolimus-Associated Reversible Cerebral Vasospasm Syndrome?

Authors :: Bloom J
Collins ML
Belovsky MP
Feduska E
Schofield P
Leong R
Augoustides JG
Lembrikov I
Kogan A
Frogel J
Rajkumar KP
Hicks MH
Fernando RJ
Source :: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2023 Aug; Vol. 37 (8), pp. 1487-1494. Date of Electronic Publication: 2023 Apr 06.
Publication Year :: 2023
Abstract: TACROLIMUS, a mainstay of immunosuppression after orthotopic heart transplantation (OHT), is associated with a broad range of side effects. Vasoconstriction caused by tacrolimus has been proposed as a mechanism underlying common side effects such as hypertension and renal injury. Neurologic side effects attributed to tacrolimus include headaches, posterior reversible encephalopathy syndrome (PRES), or reversible cerebral vasospasm syndrome (RCVS). Six case reports have been published describing RCVS in the setting of tacrolimus administration after OHT. The authors report a case of perfusion-dependent focal neurologic deficits attributed to tacrolimus-induced RCVS in an OHT recipient.<br />Competing Interests: Conflict of Interest None.<br /> (Copyright © 2023 Elsevier Inc. All rights reserved.)

Subjects :: Humans
Tacrolimus adverse effects
Critical Illness
Perfusion adverse effects
Vasospasm, Intracranial chemically induced
Vasospasm, Intracranial diagnostic imaging
Posterior Leukoencephalopathy Syndrome chemically induced
Posterior Leukoencephalopathy Syndrome diagnostic imaging
Heart Transplantation adverse effects

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