Hara Takeshi, Fujii Ryosuke, Ohno Shinsuke, Tomita Yoshiyuki, Tsunoda Akira, Maruki Chikashi, Kurokawa Shigeo
Department of Neurosurgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, Koshigaya-shi, Saitama 343-8577, Japan.
No Shinkei Geka. 2008 Dec;36(12):1145-8.
We report a case of intracranial hemorrhage due to amphetamine abuse in a young adult. A 34-year-old, confused woman was transferred to our emergency room with right hemiparesis and aphasia. CT at admission demonstrated intracerebral hemorrhage in the left frontal and parietal lobes, associated with subarachnoid hemorrhage. MRA shortly after admission revealed no intracerebral vascular anomaly. Cerebral angiography following admission showed irregularity of the vessel wall in the left anterior and middle cerebral arteries. Later, a toxicology screen test for urine was found to be positive for amphetamines and metamphetamines. These findings suggested that cerebral vasculitis and hypertensive surge induced by amphetamines caused intracranial and subarachnoid hemorrhage. Amphetamine abuse should always be considered as a cause of intracranial hemorrhage in young adults.
我们报告一例年轻成年人因滥用安非他命导致颅内出血的病例。一名34岁、意识模糊的女性因右侧偏瘫和失语被转送至我们的急诊室。入院时的CT显示左额叶和顶叶脑出血,并伴有蛛网膜下腔出血。入院后不久的MRA显示无脑血管异常。入院后的脑血管造影显示左大脑前动脉和大脑中动脉血管壁不规则。后来,尿液毒理学筛查试验发现安非他命和甲基安非他命呈阳性。这些发现提示,安非他命引起的脑血管炎和高血压激增导致了颅内和蛛网膜下腔出血。在年轻成年人中,滥用安非他命应始终被视为颅内出血的一个病因。