Document Detail


Intracerebral haemorrhage and drug abuse in young adults.
MedLine Citation:
PMID:  11198766     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The epidemic of abuse of the so-called 'designer drugs' amphetamine, cocaine and ecstasy--is fast replacing traditional aetiological factors as the largest cause of intracerebral haemorrhage among young adults. Traditional teaching is that these represent hypertensive haemorrhages. Recent reports, however, have indicated that these patients may harbour underlying vascular malformations. We review 13 patients with a positive history of drug abuse preceding the onset of intracerebral haemorrhage. These patients presented to the National Hospital for Neurology and Neurosurgery in central London over a 7-month period. Of the 13 patients (eight male, five female), average age 31 years (19-43) years), 10 were well enough to undergo cerebral angiography. Intracranial aneurysms were demonstrated in six patients and arteriovenous malformations in three patients. In only one of the patients was the angiogram normal. A further patient was subsequently shown to have a middle cerebral artery aneurysm at autopsy. The epidemiology, pharmacology and systemic effects of these drugs are considered. The mechanisms by which these compounds cause intracerebral complications and their influence on prognosis are discussed. The incidence of intracerebral haemorrhage (ICH), ischaemic cerebral infarctions and subarachnoid haemorrhage (SAH) following drug abuse is increasing. Contrary to historical opinion, drug-related ICH is frequently related to an underlying vascular malformation. Arteriography should be part of the evaluation of most young patients with nontraumatic ICH. A thorough history focusing on the use of illicit substances and toxicological screening of urine and serum should be part of the evaluation of any young patient with a stroke.
Authors:
A W McEvoy; N D Kitchen; D G Thomas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of neurosurgery     Volume:  14     ISSN:  0268-8697     ISO Abbreviation:  Br J Neurosurg     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2001-01-25     Completed Date:  2001-02-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8800054     Medline TA:  Br J Neurosurg     Country:  England    
Other Details:
Languages:  eng     Pagination:  449-54     Citation Subset:  IM    
Affiliation:
University Department of Neurosurgery, University College London, Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. a.mcevoy@ion.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Amphetamine-Related Disorders / complications,  epidemiology
Arteriovenous Malformations / complications*,  diagnosis
Cerebral Angiography
Cerebral Hemorrhage / chemically induced,  epidemiology,  etiology*
Cocaine-Related Disorders / complications,  epidemiology
Female
Humans
Intracranial Aneurysm / complications*,  diagnosis
Male
N-Methyl-3,4-methylenedioxyamphetamine
Prognosis
Substance-Related Disorders / complications*
Chemical
Reg. No./Substance:
42542-10-9/N-Methyl-3,4-methylenedioxyamphetamine

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