Adle-Biassette H, Marc B, Benhaiem-Sigaux N, Durigon M, Gray F
Département de Pathologie, Hôpital Henri Mondor, CRETEIL.
Arch Anat Cytol Pathol. 1996;44(1):12-7.
Cerebral infarcts complicating heroin abuse have been seldom reported and only clinically and radiologically documented. We report a pathological case of cerebral infarct in a heroin sniffer. A 31 year old, male, heroin sniffing addict for several years, with no known past neurological history, was found dead one morning. The evening before, he had presented the usual signs of recent heroin intake. Opiates were found in large amounts in blood and urine. Post mortem HIV serology was negative. Post mortem examination revealed the usual signs of heroin addiction, but no cutaneous signs of IV drug use. Myocardial ischemic lesions of various ages involved the anterolateral part of the left ventricle; coronary arteries were normal. Neuropathological study revealed, partly cystic infarcts involving both cerebral hemispheres. They were mostly cortical with an intralaminar pattern and a watershed distribution at the boundaries between the territories of the anterior and middle cerebral arteries and the middle posterior cerebral arteries. Intracerebral vessels, large intracranial and cervical arteries were normal.
海洛因滥用并发脑梗死的病例鲜有报道，仅有临床和影像学记录。我们报告一例海洛因吸食者脑梗死的病理病例。一名31岁男性，有多年海洛因吸食成瘾史，既往无已知神经病史，某天早晨被发现死亡。前一晚，他出现了近期吸食海洛因后的常见体征。血液和尿液中检测出大量阿片类物质。尸检HIV血清学检测为阴性。尸检发现了海洛因成瘾的常见体征，但无静脉注射吸毒的皮肤体征。不同年龄段的心肌缺血性病变累及左心室前外侧部分；冠状动脉正常。神经病理学研究显示，双侧大脑半球出现部分囊性梗死。梗死灶大多位于皮质，呈层内模式，在前大脑动脉和中大脑动脉以及中后大脑动脉供血区域边界处呈分水岭分布。脑内血管、颅内大血管和颈内动脉均正常。
