Intracranial hemorrhage after prehospital administration of intramuscular epinephrine

Joel T. Levis, Jonathan B Ford, Albert M. Kuo

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: The administration of epinephrine by the intramuscular route can be life-saving in cases of anaphylaxis or severe allergic reactions. However, the use of this drug can lead to a rapid rise in blood pressure, which theoretically could lead to deleterious effects in patients of any age, with elderly patients at greatest risk. Objectives: To present a rare case of intracranial hemorrhage potentially resulting from the administration of intramuscular epinephrine in an elderly patient with an allergic reaction. Case Report: We present a case report of a 65-year-old woman who developed an intracranial hemorrhage after a single, therapeutic, intramuscular dose of epinephrine for a wasp sting to the tongue. The patient underwent successful craniotomy with evacuation of the intracranial hematoma. Conclusions: In circumstances where the severity of the allergic reaction remains unclear (lack of airway compromise, cardiovascular collapse, or true anaphylaxis), careful consideration of the potential risks of intramuscular epinephrine, such as a rapid rise in blood pressure leading to intracranial hemorrhage, should be undertaken when using this medication in elderly patients.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
Issue number6
StatePublished - Jun 2011


  • anaphylaxis
  • emergency department
  • epinephrine
  • intracranial hemorrhage
  • intramuscular

ASJC Scopus subject areas

  • Emergency Medicine


Dive into the research topics of 'Intracranial hemorrhage after prehospital administration of intramuscular epinephrine'. Together they form a unique fingerprint.

Cite this