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.