Recurrent cerebral intraparenchymal hemorrhage after ayahuasca consumption: a case report

Abstract

Case report: A 57-year-old woman was referred to our service after noticing difficulty in coordinating the movements of the right hand. The symptoms occurred after she consumed ayahuasca in a religious ceremony and persisted after the psychedelic effects weaned off. On the first evaluation, she had right hemiataxia and increased blood pressure (200/100 mmHg). The head computed tomography (CT) scan revealed a left basal ganglia hemorrhage. No abnormalities were found on CT angiography. The patient later reported that a few years earlier, she was diagnosed with a hemorrhagic stroke at another hospital, which also happened within a few hours of ayahuasca intake. However, she has not stopped using it monthly since then. Discussion: Ayahuasca is a potent plant-based hallucinogenic brew used traditionally for spiritual and medicinal purposes. The substance responsible for its effects is Dimethyltryptamine (DMT), which is known to be a potent serotonin receptor agonist, especially the 5HT2A. This substance may induce an acute raise in blood pressure and consequently trigger a hemorrhagic stroke. To this date, there are no cases reported of hemorrhagic stroke after using this drug. Conclusion: Although ayahuasca has been associated with spiritual and therapeutic benefits, its potential risks should not be ignored, including serious complications, such as hemorrhagic stroke.