Brain computed tomographic scan findings in acute opium overdose patients

Jamshidi, Farkhondeh; Sadighi, Babak; Ali, Kamran; Sanaei‐Zadeh, Hossein; Emamhadi, Mohammad Ali; Zamani, Nasim

doi:10.1016/j.ajem.2012.05.030

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…The Kolmogorov-Smirnov test was used to determine normality of continuous Opioid intoxication (e.g. heroin or morphine) (19) Cardiovascular failure (31) n.a Trauma with loss of blood (9) Methadone intoxication (27) Metabolic disease (5) Combined intoxication (opioids and methadone) (9) Respiratory disease 3Asphyxia 3Infection 2Other/unknown (2) variables. Pearson's chi-squared tests were used to evaluate the relationship between findings in PMCT and drug-death cases.…”

Section: Discussionmentioning

confidence: 99%

“…The following findings were evaluated on CT: (1) Cerebral oedema, defined as brain swelling with effacement of cerebral sulci and loss of grey-white matter distinction [25][26][27]. 2Pulmonary oedema, defined as interstitial or alveolar fluid accumulation in the lung with ground-glass opacities, parenchymal consolidation and interlobular septal thickening with a subjective graduation in mild, moderate and severe [28].…”

Section: Radiological Criteriamentioning

confidence: 99%

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Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Radiological Criteriamentioning

confidence: 99%

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

et al. 2014

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“…These findings included infarction, hemorrhage, cerebral edema, and basal ganglia changes in one patient. A similar study by Jamshidi et al [11] on patients with acute opioid overdose found that abnormal brain CT findings were present in approximately 20% of patients who underwent CT for examination due to severe symptoms. Furthermore, presence of abnormal CT findings was associated with a poor prognosis.…”

Section: Discussionmentioning

confidence: 74%

Bilateral Basal Ganglia Lesions in Patients with Heroin Overdose: A Report of Two Cases

Hassan¹,

Jawad

Alsaihati

et al. 2019

Case Rep Acute Med

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The prevalence of opioid use has increased worldwide. Two-thirds of deaths caused by drug overdose are opioid-related. Individuals with opioid use may present with a variety of complications. The available history in unconscious patients is often insufficient, which may cause diagnostic difficulty and delayed management. We present two cases of 54-year-old and 25year-old male patients who were brought to our emergency department after being found unconscious at home, without any known preceding event. They were in a deep coma with a Glasgow coma score of 3/15. However, their brainstem reflexes were normal. Pinpoint pupils were observed bilaterally. Brain computed tomography (CT) demonstrated the presence of bilateral basal ganglia hypodensities in both patients, in addition to multiple hypodensities scattered in the cerebral hemispheres of one patient. Toxicology screening from both patients was positive for opioids. The patients were transferred to the intensive care unit for supportive management. One patient recovered completely, whereas the other remained in a vegetative state. The presence of bilateral basal ganglia lesions in brain CT in unconscious patients should alert the physician of opioid use disorder among these patients.

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“…The outcome of patients with narcotic overdose and abnormal CT scan findings was not good in previous findings although this patient was lucky. Twenty percent of patients with acute opium overdose had abnormal brain CT findings (infarct / ischemia); and they had poor prognosis in one report [8]. This is one reason for doing case report.…”

Section: Discussionmentioning

confidence: 98%

Fentanyl Overdose Presented with Unconsciousness, Hypoxia, Hypotension and Pinpoint Pupil Complicated by Acute Kidney Injury and Right Hemiparesis: A Rare Case Report

2023

CCR

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A 25-years-old -male was found unconscious with empty fentanyl ampule; slow breathing with central cyanosis; SaO2 85% on air; blood pressure 90/50 mmHg, pulse rate 100/minutes; respiratory rate 12/minutes; central cyanosis; crackles in both lungs; multiple venipuncture marks in his left forearm and pinpoint pupil. He was treated as fentanyl overdose with intravenous naloxone, fluid therapy, ventilatory support and oxygenation. Right hemiparesis was noted on recovery; CT scan head showed multiple areas of infarction in basal ganglia and cerebral hemisphere. Acute kidney injury recovered with hemodialysis.

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Brain computed tomographic scan findings in acute opium overdose patients

Cited by 8 publications

References 9 publications

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

Post-mortem whole body computed tomography of opioid (heroin and methadone) fatalities: frequent findings and comparison to autopsy

Bilateral Basal Ganglia Lesions in Patients with Heroin Overdose: A Report of Two Cases

Fentanyl Overdose Presented with Unconsciousness, Hypoxia, Hypotension and Pinpoint Pupil Complicated by Acute Kidney Injury and Right Hemiparesis: A Rare Case Report

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