FATAL INTRACEREBRAL HEMORRHAGE DURING DENTAL TREATMENT

Although chronic arterial hypertension is the leading cause of intracr anial hemorrhage, an abrupt rise in systemic arterial pressure in norm otensive people may sometimes induce a hemorrhagic stroke, Dental trea tment is rarely associated with such an event. We report here on two m iddle-aged women, apparently healthy, who suffered from a fatal intrac erebral hemorrhage following a dental treatment, On admission, high le vels of arterial hypertension were found. It seems that trigeminal man ipulation during dental treatment as well as increased serum levels of induced epinephrine mainly by stress and pain, and the small amounts absorbed from the site of local anesthesia might produce abrupt elevat ion of blood pressure, subsequent increase in cerebral blood flow and severe, even fatal intracerebral hemorrhage. The addition of catechola mines to local anesthetics should be considered. We recommend the use of benzodiazepin as a premedication drug to reduce stress during denta l treatment.