Patient: A man in his 50s living in Nottingham, UK.
Symptoms: A man suddenly developed numbness and light-headedness on the left side of his body.
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A CT angiogram, a scan that shows details of blood vessels, including blockages and damage, showed signs that the man may have experienced sudden spasms and narrowing of cerebral arteries, a phenomenon known as reversible cerebral vasoconstriction syndrome (RCVS). Additionally, MRI showed tissue death in the thalamus, which acts as a relay point for motor and sensory information. Specifically, there was damage to the thalamus on the right side of the brain.
The patient’s examination revealed no other notable findings, and his medical history had no history of smoking, alcohol use, or drug abuse. The report described him as “normally healthy and well.”
Diagnosis: The man was diagnosed with right thalamic lacunar stroke. A lacunar stroke occurs when a blood vessel that carries blood to one of the deep structures of the brain becomes blocked. Strokes on the right side affect sensation and movement on the left side of the body, and vice versa.
Treatment: While in the hospital, the man received a combination of physical and occupational therapy and was started on blood thinners to prevent the stroke from happening again. He also started taking medication to lower his cholesterol and blood pressure.
The man had several follow-up appointments scheduled over the next three months. “Although his sensory symptoms remained, he appeared to have made an excellent functional recovery.” [of numbness] Her blood pressure remained persistently high, so she started taking additional antihypertensive medication.
At that point, the doctors asked more questions about the patient’s lifestyle and learned that the patient was consuming an average of eight cans of “high-potency” energy drinks each day. Each can contains 160 milligrams of caffeine per 16 fluid ounces, giving you up to about 1.2 grams of caffeine per day. (A safe intake of caffeine per day is considered to be less than 400 milligrams.)
The patient was advised to stop consuming energy drinks, and his blood pressure quickly fell to normal levels. He was able to stop taking all of his prescribed medications within three weeks of stopping drinking.
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“Further follow-up after 3 and 6 months showed complete resolution of hypertension, complete recovery from stroke, and full return to work,” the doctors reported. Eight years later, he had no further strokes, but still had sensory issues on his left side from the first stroke.
What makes this case unique is that although the man was otherwise healthy, it appears that overconsumption of energy drinks caused his high blood pressure and subsequent stroke.
The authors of the case report noted that high levels of caffeine were likely a major culprit, but hypothesized that other common ingredients found in energy drinks may contribute to stroke risk. For example, the researchers theorized that the blood pressure raising and vasoconstricting effects of stimulants may be amplified when combined with caffeine, taurine, and guarana. Taurine, an amino acid, is often added to energy drinks for its performance-enhancing effects, but guarana is a plant that is also thought to have health benefits, and its seeds contain caffeine.
Additionally, many energy drinks are high in sugar, which can cause inflammation and dysfunction in the lining of blood vessels, further increasing your risk.
The authors cited a small number of published medical case reports linking excessive consumption of energy drinks or individual energy drink ingredients to cardiovascular problems, including dangerous high blood pressure.
They concluded that “acute and chronic consumption” of energy drinks may increase the risk of cardiovascular disease and stroke.
“Medical professionals should consider specific questions related to ED.” [energy drink] Young patients with stroke or unexplained high blood pressure have lower intakes,” the researchers concluded. Importantly, he added, the risk appears to be reversible, given that quitting energy drinks appears to resolve the associated problems.
For his part, the patient said: “I clearly was not aware of the risks to myself of drinking energy drinks. [I] Numbness remained [in my] Even after 8 years, I still have problems with my left hand, fingers, feet, and toes. ”
For more interesting medical cases, check out our Diagnostic Dilemma archives.
This article is for informational purposes only and does not provide medical advice.
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