Cerebrovascular Complications of Methamphetamine Abuse
Cerebrovascular Complications of Methamphetamine Abuse
复制标题
DOI：
10.1007/s12028-008-9177-5
复制
发表时间：
2009-06-01
影响因子：
3.5
通讯作者：
Smith, Wade S.
中科院分区：
文献类型：
--
作者：
Ho, Emily L.;Josephson, S. Andrew;Smith, Wade S.
甲基苯丙胺是一种兴奋剂，在美国被广泛滥用。本研究的目的是证明甲基苯丙胺的使用与缺血性中风、蛛网膜下腔出血和脑出血的关系，并通过神经影像学和病理学进一步揭示潜在的血管病理。本研究基于2003年1月至2007年7月某三级医疗中心神经血管科住院病人的病历回顾。病例包括使用甲基苯丙胺的病史或尿液毒理学筛查记录的患者。从1574份记录中，确定了30例病例。患者平均年龄43岁，出院诊断包括缺血性脑卒中、脑出血、蛛网膜下腔出血。所有蛛网膜下腔出血均为动脉瘤性出血，大多数动脉瘤位于前循环。大多数中风发生在前循环。在许多病例中，放射学成像证实了卒中血管分布中的动脉狭窄。1例缺血性卒中患者有严重的双侧颈总动脉、颈内动脉和颈外动脉粥样硬化。在病理上，没有炎症或坏死的证据表明血管炎是可能的病因。甲基苯丙胺的使用与缺血性中风、脑出血和蛛网膜下腔出血有关，尤其是在年轻患者中。我们没有证据表明与甲基苯丙胺使用相关的缺血性中风是由于炎症病因，但可能是由于动脉粥样硬化加速的过程。
Methamphetamine is a stimulant widely abused in the United States. The objective of this study was to demonstrate an association of methamphetamine use and ischemic stroke, subarachnoid hemorrhage, and intracerebral hemorrhage and to further reveal the underlying vascular pathology using neuroimaging and pathology.This was a retrospective study based on medical chart review of admissions to the neurovascular service of a tertiary care medical center from January 2003 to July 2007. Cases included patients who used methamphetamine as documented by history or urine toxicology screening.From 1,574 records, 30 cases were identified. The mean age of patients was 43 years and the discharge diagnoses included ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. All subarachnoid hemorrhages were aneurysmal with the majority of the aneurysms located in the anterior circulation. The majority of strokes were located in the anterior circulation. In many cases, radiologic imaging confirmed arterial stenoses in the vascular distribution of the stroke. One patient who presented with ischemic stroke had severe atherosclerosis of bilateral common, internal, and external carotid arteries. On pathology, there was no evidence of inflammation or necrosis to suggest vasculitis as a possible etiology.Methamphetamine use is associated with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage, especially among young patients. We showed no evidence that the ischemic stroke associated with methamphetamine use is due to an inflammatory etiology but may be due to a process of accelerated atherosclerosis.