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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.
Journal of Neurointerventional Surgery
|July 10, 2014
Summary
This case study highlights a rare posterior spinal artery (PSA) aneurysm rupture in a teenager after 3,4-methylenedioxymethamphetamine (MDMA) use. Surgical excision of the PSA aneurysm was successful, with no neurological deficits.
Area of Science:
- Neurology
- Vascular Surgery
- Toxicology
Background:
- Posterior spinal artery (PSA) aneurysms are an uncommon cause of subarachnoid hemorrhage (SAH).
- 3,4-methylenedioxymethamphetamine (MDMA), or 'Ecstasy', is associated with various systemic and neurological complications.
- Drug-induced vasculitis and hemorrhage are known neurological sequelae of MDMA use.
Observation:
- A teenager presented with symptoms suggestive of SAH after 'Ecstasy' consumption.
- Initial imaging revealed no intracranial SAH but suggested cerebral vasculitis; lumbar puncture confirmed SAH.
- Spinal imaging identified a left PSA aneurysm, a rare finding linked to drug use.
Findings:
- A 2mm left PSA fusiform aneurysm was diagnosed via spinal angiography.
- Surgical excision of the PSA aneurysm was performed successfully.
- The patient experienced no postoperative neurological complications.
Implications:
- MDMA use may trigger neurovascular inflammation, leading to intracranial hemorrhage, SAH, and potentially de novo aneurysm formation.
- This case highlights the importance of considering drug-induced vasculitis and aneurysm formation in patients presenting with SAH.
- Posterior spinal artery aneurysms can be effectively managed through surgical excision or endovascular occlusion.