heroin and Cerebral-Infarction

Hypereosinophilic syndrome represents a rare cause for cerebral infarctions and inflammatory neurological disorders. Various possible pathogenic mechanisms for cerebral infarctions have already been discussed. Complex mechanisms including a local hypercoagulability by eosinophilic granules as well as a direct damage to endothelial cells, leading to alterations of the microcirculation seem to be involved. The changing pattern of heroin use to inhalation/sniffing leading to an increasing abuse may cause a rise in the prevalence of Heroin induced eosinophilia, as it has been reported in a case of eosinophilic pneumonia associated with heroin inhalation. To our knowledge, the present case report displays the first description of stroke in the setting of heroin induced hypereosinophilia. Thus, besides usual vasoconstriction, HES should be considered in drug-induced cerebral infarctions.

Topics: Adult; Cerebral Infarction; Heroin; Humans; Hypereosinophilic Syndrome; Magnetic Resonance Imaging; Male

There are several complications associated with heroin abuse, some of which are life-threatening. Methadone may aggravate this problem.. A clinical case description.. A 33-year-old man presented with rhabdomyolysis and cerebral ischemic stroke after intravenous heroin. He had used heroin since age 20, and had used 150 mg methadone daily for 6 months. He was found unconsciousness at home and was sent to our hospital. In the ER, his opiate level was 4497 ng/ml. In the ICU, we found rhabdomyolysis, acute renal failure and acute respiratory failure. After transfer to an internal ward, we noted aphasia and weakness of his left limbs. After MRI, we found cerebral ischemic infarction.. Those using methadone and heroin simultaneously may increase risk of rhabdomyolysis and ischemic stroke. Patients under methadone maintenance therapy should be warned regarding these serious adverse events. Hypotheses of heroin-related rhabdomyolysis and stroke in heroin abusers are discussed.

Topics: Adult; Brain; Brain Damage, Chronic; Cerebral Cortex; Cerebral Hemorrhage; Cerebral Infarction; Dominance, Cerebral; Drug Interactions; Electroencephalography; Heroin; Heroin Dependence; Humans; Intensive Care Units; Magnetic Resonance Imaging; Male; Methadone; Narcotics; Rhabdomyolysis; Substance Abuse Treatment Centers; Substance Abuse, Intravenous; Tomography, X-Ray Computed

Topics: Adult; Cerebral Cortex; Cerebral Infarction; Drug Synergism; Globus Pallidus; Heroin; Heroin Dependence; Humans; Male; Methadone; Narcotics; Neurologic Examination; Rhabdomyolysis; Substance Abuse Treatment Centers; Substance Abuse, Intravenous

Three hours after sniffing a dose of heroin, a 30-year old man developed right hemiplegia with aphasia. Magnetic resonance imaging of the brain showed an infarct in the territory of the left anterior choroid artery. Cerebral vascular accidents occurring as complications of heroin addiction are rare: a review of the literature yielded only 13 documented cases. The main characteristics of these strokes are analysed and their pathogenetic mechanisms (immuno-allergic vasculitis, vascular spasm) are discussed.

Topics: Administration, Inhalation; Adult; Cerebral Infarction; Heroin; Heroin Dependence; Humans; Magnetic Resonance Imaging; Male; Radiography