Caudal thalamic infarction following intranasal methamphetamine use

Sachdeva, Kamal K.; Woodward, Keith

doi:10.1212/wnl.39.2.305-a

Cited by 24 publications

(8 citation statements)

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“…6,20,21 The majority of infarctions are described as secondary to acutely organized thrombus in cerebral vessels affected by necrosis associated with vasculitis. Cerebral vasculitis is the most commonly described histologic and radiologic finding in abusers of MA with either hemorrhagic or ischemic strokes.…”

Section: Discussionmentioning

confidence: 99%

“…CVAs have occurred with all modes of MA ingestion, including oral intake, inhalation, and intravenous injection. 17,20,21,25 Reports have contemplated whether ischemic strokes are associated to the inhalation of MA, while oral and intravenous injection show a predilection for cerebral hemorrhage. 6,8,14,21 The deceased in our case inhaled MA and suffered from a fatal ICH and SAH without evidence of infarction or vasculitis (Table 1).…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Intracerebral Hemorrhage Related to Methamphetamine Abuse

McGee¹,

McGee²,

McGee³

2004

American Journal of Forensic Medicine &Amp; Pathology

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A healthy 31-year-old male abstinent from drug abuse during his recent incarceration developed slurred speech, a severe headache, and left-sided hemiparesis prior to his eventual death 9.5 hours after inhalation of methamphetamine. On postmortem examination, inspection of the brain revealed bilateral subarachnoid hemorrhage, with a prominent intralobar hemorrhage centered within the right frontal cerebral hemisphere. No evidence of vasculitis, infarction, intraventricular hemorrhage, or ruptured aneurysm could be observed. While this is not the first report of a methamphetamine-related stroke, this report describes the autopsy findings of an intracerebral hemorrhage secondary to methamphetamine abuse on autopsy and compares the findings and antemortem history to previously reported methamphetamine cerebral vascular deaths.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Intracerebral Hemorrhage Related to Methamphetamine Abuse

McGee¹,

McGee²,

McGee³

2004

American Journal of Forensic Medicine &Amp; Pathology

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“…However, the reported cases of strokerelated events after methamphetamine inhalation are few [3,15,16]. Harrington et al [3] have reported a 19-yearold man who had ICH in his left hemisphere 16 days after inhalation of a mixture of amphetamine and LSD.…”

Section: Discussionmentioning

confidence: 99%

“…All their angiographic studies revealed stenosis or occlusion of internal carotid arteries (ICA). Recently, Sachdeva and Woodward [ 16] reported the occurrence of a caudal tha lamic (posterior circulation) infarction in a 45-year-old man 36 h after methamphetamine inhalation. In contrast, our studies found that hemorrhagic strokes (n = 5) were more frequent than ischemic strokes (n = 2) after meth amphetamine inhalations.…”

Section: Discussionmentioning

confidence: 99%

Stroke Associated with Methamphetamine Inhalation

Yen

Wang

et al. 1994

Eur Neurol

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Seven patients (all men, mean age 32 years, range 17-47) with stroke following methamphetamine inhalation were collected during the last 2 years. Like oral or intravenous abusers, our patients had more hemorrhagic (n = 5) than ischemic strokes (n = 2). Cases of intracerebral hemorrhage (ICH) were lobar (n = 3), caudate (n = 1) or putaminal (n = 1), whereas the infarctions were both in the middle cerebral artery region. Each stroke event occurred within 3 days after drug use. Three patients had hypertension on admission. Though young in age, most patients had multiple stroke risk factors. In 3 patients with ICH, we also found small, low attenuated lesions on the brain computed tomography, however, without clinical correlations. Except for arteriovenous malformation in 1 patient, all angiograms failed to show vasculopathy or vasospasm. Contrary to what one might surmise from previously published reports, methamphetamine inhalation is at least as likely to produce ICH as it is to produce brain infarction.

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“…So, intracranial haemorrhage is probably not only caused by an acute increase in blood pressure, but also by high blood pressure in the setting of structural blood vessel changes, either as a direct result of hypertension (usually chronic hyperten sion causing small vessel fibrinoid degeneration) or unre lated to hypertension [7], such as rupture of a congenital structural vessel wall abnorm ality [8], a vascular malfor m ation [9] or a vessel that has been damaged by am phet amine-induced vasculitis [10]. Amphetam ine-induced vasculitis may affect large basal and small intraparenchymal vessels [10][11][12][13][14]. Possible mechanisms are vessel reac tions to hypertension and acute and chronic allergic vas culitis, either in reaction to injected foreign body material or to the drug itself [10][11][12]15].…”

Section: Discussionmentioning

confidence: 99%

Amphetamine-Associated Stroke

Heye¹,

Hankey

1996

Cerebrovasc Dis

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Seven patients with presumed amphetamine-associated stroke are reported. Ischaemic stroke occurred in four patients, a transient ischaemic attack in one patient and a haemorrhagic stroke in two patients. All patients had used amphetamines within hours of the onset of focal neurological symptoms, but drug abuse was not admitted by three patients until 4, 5 and 8 weeks, respectively, after the admission. Other predisposing factors, besides concurrent alcohol abuse (n = 6), were present in only one patient (pro-coagulant state and protein-S deficiency). Amphetamine-associated stroke is heterogeneous clinically, pathologically and aetiologically. Drug abuse should always be considered in young patients with stroke, even if the patient denies the use of recreational drugs and if other stroke risk factors are present.

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Caudal thalamic infarction following intranasal methamphetamine use

Cited by 24 publications

References 0 publications

Spontaneous Intracerebral Hemorrhage Related to Methamphetamine Abuse

Spontaneous Intracerebral Hemorrhage Related to Methamphetamine Abuse

Stroke Associated with Methamphetamine Inhalation

Amphetamine-Associated Stroke

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