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Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse
Jeremiah Johnson1, Shnehal Patel2, Efrat Saraf-Lavi3
1Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
BMJ Case Reports
|July 5, 2014
Summary
This study reports a rare case of a posterior spinal artery aneurysm causing subarachnoid hemorrhage in a teenager after using Ecstasy. Surgical excision was successful, highlighting the neurovascular risks of MDMA.
Area of Science:
- Neuroscience
- Vascular Surgery
- Toxicology
Background:
- Posterior spinal artery (PSA) aneurysms are infrequent causes of subarachnoid hemorrhage (SAH).
- 3,4-methylenedioxymethamphetamine (MDMA), or 'Ecstasy', is associated with systemic and neurological adverse effects.
Observation:
- A teenager experienced symptoms of SAH after MDMA use.
- Initial imaging was inconclusive for SAH, but suggested cerebral vasculitis.
- Spinal imaging ultimately revealed a left PSA aneurysm.
Findings:
- A 2mm left PSA fusiform aneurysm was identified and surgically excised.
- The patient had no postoperative neurological deficits.
- MDMA use may precipitate neurovascular inflammation, hemorrhage, and de novo aneurysm formation.
Implications:
- This case underscores the potential for MDMA to induce serious neurovascular complications, including PSA aneurysms.
- Treatment options for PSA aneurysms include endovascular occlusion and surgical excision.
- Awareness of Ecstasy's neurovascular risks is crucial for clinicians.