Johnston James C
Legal Medicine Consultants, Seattle, WA, USA.
J Forensic Leg Med. 2009 Nov;16(8):489-91. doi: 10.1016/j.jflm.2009.07.006. Epub 2009 Aug 13.
A 45 year old female with no stroke risk factors suffered a massive intracerebral hemorrhage (ICH) after ingesting Midrin--a combination of isometheptene mucate, dichlorophenazine and acetaminophen. Neuroimaging revealed no evidence of structural disease or underlying vasculopathy. This is the first reported case of isometheptene induced ICH in the absence of underlying cerebrovascular disease. Physicians must be aware of the potential for this complication, and inquire about the use of isometheptene in unexplained cerebral hemorrhages. Neurological communities in countries with nonprescription isometheptene should discourage unsupervised or excessive use of the drug.
一名45岁无中风危险因素的女性在服用米得林（一种由樟柳碱、二氯苯嗪和对乙酰氨基酚组成的复方制剂）后发生大量脑出血（ICH）。神经影像学检查未发现结构性疾病或潜在血管病变的证据。这是首例在无潜在脑血管疾病情况下由樟柳碱诱发脑出血的报道病例。医生必须意识到这种并发症的可能性，并在不明原因脑出血病例中询问樟柳碱的使用情况。在樟柳碱为非处方药的国家，神经学界应不鼓励无监督或过度使用该药物。
