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Stroke associated with methamphetamine inhalation
Abstract:
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.
Insights
Methamphetamine inhalation frequently causes hemorrhagic stroke, even in young adults. This drug use is as likely to cause intracerebral hemorrhage as brain infarction.
Area of Science:
- Neurology
- Toxicology
- Public Health
Background:
- Methamphetamine abuse is a growing public health concern.
- Stroke is a known complication of methamphetamine use, but the specific type of stroke is debated.
- Understanding the relationship between methamphetamine and stroke is crucial for clinical management and prevention.
Purpose of the Study:
- To investigate the characteristics of stroke events in patients following methamphetamine inhalation.
- To compare the incidence of hemorrhagic versus ischemic stroke in this population.
- To identify potential stroke risk factors associated with methamphetamine use.
Main Methods:
- Retrospective case series of seven patients admitted with stroke within 3 days of methamphetamine inhalation.
- Clinical data collection including demographics, medical history, and stroke risk factors.
- Neuroimaging including computed tomography (CT) and angiography to evaluate stroke type and vascular abnormalities.
Main Results:
- Five out of seven patients experienced hemorrhagic stroke (intracerebral hemorrhage), while two had ischemic stroke.
- Hemorrhagic strokes occurred in various brain regions (lobar, caudate, putaminal).
- Ischemic strokes were located in the middle cerebral artery (MCA) territory. Most patients were young and had multiple stroke risk factors, including hypertension in three.
- Angiography revealed vasculopathy or vasospasm in only one patient with arteriovenous malformation.
Conclusions:
- Methamphetamine inhalation is a significant cause of stroke in young adults.
- Intracerebral hemorrhage is as common, if not more common, than ischemic stroke following methamphetamine inhalation.
- The findings challenge previous assumptions about the predominant stroke type associated with methamphetamine use.