Stroke and methamphetamine use in young adults: a review

Area of Science:

• Neurology
• Public Health
• Toxicology

Background:

• Stroke is a major health issue, less common but severe in individuals under 45.
• Methamphetamine use is increasingly recognized as a potential cause of stroke in younger populations.

Purpose of the Study:

• To review and synthesize existing literature on methamphetamine-related strokes.
• To understand the characteristics, outcomes, and potential mechanisms of these strokes.

Main Methods:

• A comprehensive literature search was performed on bibliographic databases up to February 2017.
• Articles focusing on methamphetamine and both hemorrhagic and ischemic strokes were selected for review.

Main Results:

• 77 articles reported 81 hemorrhagic and 17 ischemic strokes, predominantly in males.
• Hemorrhagic stroke was linked to oral/injecting use and vascular abnormalities; ischemic stroke to inhalation.
• Outcomes varied, with recovery rates between 20-25% and mortality rates up to 33% for hemorrhagic stroke.

Conclusions:

• Methamphetamine-related strokes, especially hemorrhagic types, are associated with poor clinical outcomes in young people.
• Potential mechanisms include hypertension, vasculitis, direct vascular toxicity, and vasospasm.
• The rising global use of methamphetamine is expected to increase the incidence and burden of these strokes.