A fatal case of pontine hemorrhage related to methamphetamine abuse

Miyashita, Tomoko; Hayashi, Takahito; Ishida, Yuko; Tsuneyama, Koichi; Kimura, Akihiko; Kondo, Toshikazu

doi:10.1016/j.jflm.2007.01.006

Cited by 14 publications

(9 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Methamphetamine is a potent sympathomimetic that increases the release of dopamine, norepinephrine, epinephrine, and serotonin, 15 which result in acute hypertension and tachycardia, 16 and chronic hypertension with chronic use. 17 Methamphetamine abuse is a well-known cause of spontaneous ICH, [18][19][20][21][22][23][24][25][26][27] although the exact mechanism is unclear. Some postmortem studies have suggested acute necrotizing angiitis, leading to fibrinoid necrosis, thinning of the tunica media and intima, and microaneurysm formation.…”

Section: Study Proceduresmentioning

confidence: 99%

“…Some postmortem studies have suggested acute necrotizing angiitis, leading to fibrinoid necrosis, thinning of the tunica media and intima, and microaneurysm formation. 19,[27][28][29][30][31][32] However, other studies have shown no evidence of inflammation or vasculitis, [33][34][35] suggesting that much of Meth-ICH may be attributable to cumulative burden of methamphetamine-induced high blood pressure. In fact, 96% of Meth-ICHs in our study had hematoma in a location that is consistent with hypertensive ICH, suggesting that this may be an accelerated hypertensive pathology.…”

Section: Study Proceduresmentioning

confidence: 99%

See 1 more Smart Citation

Racial disparities in methamphetamine-associated intracerebral hemorrhage

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Study Proceduresmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

Racial disparities in methamphetamine-associated intracerebral hemorrhage

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Postmortem studies showed that cerebral edema [27] or brain stem hematoma [15] is a common clinical phenotype in patients died of METH intoxication. The present study demonstrated that damage to RVLM in the form of necrotic cell death is a contributing factor to METH-induced mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Cerebrovascular pathology, most commonly hypoxia and hemorrhage, is present in 20% of cases in METH-elicited death [4], [15]. Of particular interests is that our laboratory found previously in experimental brain death models that the degree of tissue hypoxia in RVLM is a crucial determinant of the severity of central circulatory regulatory dysfunction [14], [16].…”

Section: Introductionmentioning

confidence: 99%

Bioenergetics Failure and Oxidative Stress in Brain Stem Mediates Cardiovascular Collapse Associated with Fatal Methamphetamine Intoxication

Yen²,

Chan

et al. 2012

PLoS ONE

View full text Add to dashboard Cite

BackgroundWhereas sudden death, most often associated with cardiovascular collapse, occurs in abusers of the psychostimulant methamphetamine (METH), the underlying mechanism is much less understood. The demonstration that successful resuscitation of an arrested heart depends on maintained functionality of the rostral ventrolateral medulla (RVLM), which is responsible for the maintenance of stable blood pressure, suggests that failure of brain stem cardiovascular regulation, rather than the heart, holds the key to cardiovascular collapse. We tested the hypothesis that cessation of brain stem cardiovascular regulation because of a loss of functionality in RVLM mediated by bioenergetics failure and oxidative stress underlies the cardiovascular collapse elicited by lethal doses of METH.Methodology/Principal FindingsSurvival rate, cardiovascular responses and biochemical or morphological changes in RVLM induced by intravenous administration of METH in Sprague-Dawley rats were investigated. High doses of METH induced significant mortality within 20 min that paralleled concomitant the collapse of arterial pressure or heart rate and loss of functionality in RVLM. There were concurrent increases in the concentration of METH in serum and ventrolateral medulla, along with tissue anoxia, cessation of microvascular perfusion and necrotic cell death in RVLM. Furthermore, mitochondrial respiratory chain enzyme activity or electron transport capacity and ATP production in RVLM were reduced, and mitochondria-derived superoxide anion level was augmented. All those detrimental physiological and biochemical events were reversed on microinjection into RVLM of a mobile electron carrier in the mitochondrial respiratory chain, coenzyme Q10; a mitochondria-targeted antioxidant and superoxide anion scavenger, Mito-TEMPO; or an oxidative stress-induced necrotic cell death inhibitor, IM-54.ConclusionWe conclude that sustained anoxia and cessation of local blood flow that leads to bioenergetics failure and oxidative stress because of mitochondrial dysfunction, leading to acute necrotic cell death in RVLM underpins cardiovascular collapse elicited by lethal doses of METH.

show abstract

“…Basal ganglia and white matter changes occur following poisoning due to carbon monoxide, methanol, ethylene glycol, cyanide, hydrogen sulfide, mercury, manganese, heroine, barbiturates, and solvents [12, 13]. …”

Section: Introductionmentioning

confidence: 99%

Features of Neurotoxicity on Brain CT of Acutely Intoxicated Unconscious Patients

Taheri¹,

Noori²,

Nahvi³

et al. 2010

Open Neuroimag J

View full text Add to dashboard Cite

Diagnostic imaging is a valuable device in clinical management of poisoned patients presenting to emergency units in a comatose state. Some toxic agents have adverse effects on the central nervous system (CNS). Non-contrast computed tomography (CT) of the brain, as an available diagnostic method with a high resolution, can provide useful information about structural disturbances of unconscious patients with suspected drug or chemical intoxication. The authors would describe various presentations of toxic substances detected on the brain CT scans of ten patients with acute intoxication. While non-specific, CT findings of low-attenuation lesions in the basal ganglia, infarctions in young patients, or diffuse edema should raise suspicion for poisoning or overdose.

show abstract

A fatal case of pontine hemorrhage related to methamphetamine abuse

Cited by 14 publications

References 34 publications

Racial disparities in methamphetamine-associated intracerebral hemorrhage

Racial disparities in methamphetamine-associated intracerebral hemorrhage

Bioenergetics Failure and Oxidative Stress in Brain Stem Mediates Cardiovascular Collapse Associated with Fatal Methamphetamine Intoxication

Features of Neurotoxicity on Brain CT of Acutely Intoxicated Unconscious Patients

Contact Info

Product

Resources

About