Introduction:
Anaphylaxis with rapidly life-threatening systemic hypersensitivity reactions occurring after being triggered by inflammatory mediators can lead to fatal airway obstruction and shock[1][2]. Approximate acute management of anaphylactic shock remains prompt intramuscular injection of adrenaline, which has a significant impact on favorable outcomes[3][4]. However, previous published reports have rarely shown the incidence of intracranial hemorrhage following anaphylactic shock treated with adrenaline injection[5][6]. Furthermore, intracerebral hemorrhage can occur after adrenaline administration via any route, including in patients undergoing therapeutic upper-gastrointestinal endoscopy and those with asthma[7][8]. Although a definitive pathology has not been completely established, these serious adverse events can be fatal and require further intervention. In addition, the number of elderly people with multiple comorbidities and taking many medications who are at high risk for hemorrhage may increase every year[9].
Sharing our experience may help clinicians recognize cerebrovascular complications after injection of adrenaline in elderly dialysis patients with anaphylactic shock; adrenaline injection is the first-line management for these patients.