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Der Radiologe

, Volume 58, Issue 12, pp 1054–1059 | Cite as

Schäden des Zentralnervensystems bei Drogenkonsum

  • A. Bachhuber
Leitthema
  • 157 Downloads

Zusammenfassung

Klinisches Problem

Drogen können eine Myriade an Schäden des Zentralnervensystems (ZNS) verursachen. Die Toxizität rührt sowohl von der Droge selbst als auch von Verunreinigungen her. Am häufigsten treten ischämische und hämorrhagische Schlaganfälle auf, aber auch subarachnoidale Blutungen und Leukenzephalopathien. Der Artikel verschafft eine Übersicht über die wichtigsten bildmorphologisch beschriebenen ZNS-Erkrankungen als Folge von Drogenkonsum.

Empfehlungen für die Praxis

Bei Schlaganfällen oder unklaren Leukenzephalopathien bei jungen Erwachsenen ist Drogenmissbrauch in die differenzialdiagnostischen Überlegungen mit einzubeziehen.

Schlüsselwörter

Hirnödem Leukenzephalopathie Schlaganfall Subarachnoidale Blutungen Diagnostische Bildgebung 

Damages to the central nervous system due to illicit drug use

Abstract

Clinical issue

Illicit drugs can cause a myriad of CNS damages. The toxicity might be caused by the drug itself or by diverse contaminants. The most common changes are ischemic and hemorrhagic stroke as well as subarachnoid hemorrhage and leukoencephalopathies. This article gives a review of the most important morphological imaging findings of the CNS in illicit drug users.

Practical recommendations

In cases of stroke or unclear leukoencephalopathies in young adults, the differential diagnosis of illicit drug use should be considered.

Keywords

Cerebral edema Leucoencephalopathy Stroke Subarachnoid hemorrhage Diagnostic imaging 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

A. Bachhuber gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine vom Autor durchgeführte Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Auer J, Berent R, Weber T et al (2002) Subarachnoid haemorrhage with “Ecstasy” abuse in a young adult. Neurol Sci 23:199–201CrossRefPubMedGoogle Scholar
  2. 2.
    Bahar M, Cole G, Rosen M et al (1984) Histopathology of the spinal cord after intrathecal cocaine, bupivacaine, lignocaine and adrenaline in the rat. Eur J Anaesthesiol 1:293–297PubMedGoogle Scholar
  3. 3.
    Bakheit AM (1999) Intracerebral haemorrhage in previously healthy young adults. Postgrad Med J 75:499–500CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Bartlett E, Mikulis DJ (2005) Chasing “chasing the dragon” with MRI: leukoencephalopathy in drug abuse. Br J Radiol 78:997–1004CrossRefPubMedGoogle Scholar
  5. 5.
    Blacha C, Schmid MM, Gahr M et al (2013) Self-inflicted testicular amputation in first lysergic acid diethylamide use. J Addict Med 7:83–84CrossRefPubMedGoogle Scholar
  6. 6.
    Brust JC (1993) Clinical, radiological, and pathological aspects of cerebrovascular disease associated with drug abuse. Stroke 24:I129–133 (discussion I134–125)PubMedGoogle Scholar
  7. 7.
    Buttner A (2011) Review: the neuropathology of drug abuse. Neuropathol Appl Neurobiol 37:118–134CrossRefPubMedGoogle Scholar
  8. 8.
    Calabrese LH, Dodick DW, Schwedt TJ et al (2007) Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med 146:34–44CrossRefPubMedGoogle Scholar
  9. 9.
    Chiu ZK, Bennett IE, Chan P et al (2016) Methamphetamine-related brainstem haemorrhage. J Clin Neurosci 32:137–139CrossRefPubMedGoogle Scholar
  10. 10.
    Christensen MR, Lesnikova I, Madsen LB et al (2013) Drug-induced bilateral ischemic infarction in an amphetamine addict. Forensic Sci Med Pathol 9:458–461CrossRefPubMedGoogle Scholar
  11. 11.
    Chynn KY (1975) Acute subarachnoid hemorrhage. JAMA 233:55–56CrossRefPubMedGoogle Scholar
  12. 12.
    Daras M, Tuchman AJ, Koppel BS et al (1994) Neurovascular complications of cocaine. Acta Neurol Scand 90:124–129CrossRefPubMedGoogle Scholar
  13. 13.
    Dorairaj JJ, Healy C, Mcmenamin M et al (2012) The untold truth about “bath salt” highs: a case series demonstrating local tissue injury. J Plast Reconstr Aesthet Surg 65:e37–e41CrossRefPubMedGoogle Scholar
  14. 14.
    Ebrahimi H, Haghjoo Javanmard S, Asgary S et al (2018) Opium addiction and Ischemic stroke in Isfahan, Iran: a case-control study. Eur Neurol 79:82–85CrossRefPubMedGoogle Scholar
  15. 15.
    Egan PJ, Becker FW, Schumm F (2004) Spongiform leucoencephalopathy after inhaling illicit heroin and due to carbon monoxide-intoxication. Fortschr Neurol Psychiatr 72:26–35CrossRefPubMedGoogle Scholar
  16. 16.
    Fallon JK, Shah D, Kicman AT et al (2002) Action of MDMA (ecstasy) and its metabolites on arginine vasopressin release. Ann N Y Acad Sci 965:399–409CrossRefPubMedGoogle Scholar
  17. 17.
    Filley CM, Kleinschmidt-Demasters BK (2001) Toxic leukoencephalopathy. N Engl J Med 345:425–432CrossRefGoogle Scholar
  18. 18.
    Ginat DT (2015) MRI of toxic leukoencephalopathy syndrome associated with methylenedioxymethamphetamine. Neurology 84:757CrossRefPubMedGoogle Scholar
  19. 19.
    Hamzei Moqaddam A, Ahmadi Musavi SM, Khademizadeh K (2009) Relationship of opium dependency and stroke. Addict Health 1:6–10PubMedPubMedCentralGoogle Scholar
  20. 20.
    Hannemann TV, Kraus L, Piontek D (2017) Consumption patterns of nightlife attendees in Munich: a latent-class analysis. Subst Use Misuse 52:1511–1521CrossRefPubMedGoogle Scholar
  21. 21.
    Kaku DA, Lowenstein DH (1990) Emergence of recreational drug abuse as a major risk factor for stroke in young adults. Ann Intern Med 113:821–827CrossRefPubMedGoogle Scholar
  22. 22.
    Kelly MA, Gorelick PB, Mirza D (1992) The role of drugs in the etiology of stroke. Clin Neuropharmacol 15:249–275CrossRefPubMedGoogle Scholar
  23. 23.
    Kramer CL, Wetzel DR, Wijdicks EF (2016) Devastating delayed leukoencephalopathy associated with bath salt inhalation. Neurocrit Care 24:454–458CrossRefPubMedGoogle Scholar
  24. 24.
    Lee GY, Gong GW, Vrodos N et al (2003) ‘Ecstasy’-induced subarachnoid haemorrhage: an under-reported neurological complication? J Clin Neurosci 10:705–707CrossRefPubMedGoogle Scholar
  25. 25.
    Levine SR, Brust JC, Futrell N et al (1990) Cerebrovascular complications of the use of the “crack” form of alkaloidal cocaine. N Engl J Med 323:699–704CrossRefPubMedGoogle Scholar
  26. 26.
    Miyashita T, Hayashi T, Ishida Y et al (2007) A fatal case of pontine hemorrhage related to methamphetamine abuse. J Forensic Leg Med 14:444–447CrossRefPubMedGoogle Scholar
  27. 27.
    Moritz ML, Kalantar-Zadeh K, Ayus JC (2013) Ecstacy-associated hyponatremia: why are women at risk? Nephrol Dial Transplant 28:2206–2209CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Perez JA Jr., Arsura EL, Strategos S (1999) Methamphetamine-related stroke: four cases. J Emerg Med 17:469–471CrossRefPubMedGoogle Scholar
  29. 29.
    Poon SH, Baliog CR Jr., Sams RN et al (2011) Syndrome of cocaine-levamisole-induced cutaneous vasculitis and immune-mediated leukopenia. Semin Arthritis Rheum 41:434–444CrossRefPubMedGoogle Scholar
  30. 30.
    Pozzi M, Roccatagliata D, Sterzi R (2008) Drug abuse and intracranial hemorrhage. Neurol Sci 29(Suppl 2):S269–S270CrossRefPubMedGoogle Scholar
  31. 31.
    Rodgers J, Ashton CH, Gilvarry E et al (2004) Liquid ecstasy: a new kid on the dance floor. Br J Psychiatry 184:104–106CrossRefPubMedGoogle Scholar
  32. 32.
    Rohm S, Staab H, Schulz H et al (2014) Good clinical outcome after accidental intra-arterial injection of flunitrazepam tablets in 16 drug abusers with critical limb ischaemia. Eur J Vasc Endovasc Surg 47:61–67CrossRefPubMedGoogle Scholar
  33. 33.
    Sachdeva K, Woodward KG (1989) Caudal thalamic infarction following intranasal methamphetamine use. Neurology 39:305–306CrossRefPubMedGoogle Scholar
  34. 34.
    Sammler EM, Foley PL, Lauder GD et al (2010) A harmless high? Lancet 376:742CrossRefPubMedGoogle Scholar
  35. 35.
    Shibata S, Mori K, Sekine I et al (1991) Subarachnoid and intracerebral hemorrhage associated with necrotizing angiitis due to methamphetamine abuse – an autopsy case. Neurol Med Chir (Tokyo) 31:49–52CrossRefGoogle Scholar
  36. 36.
    Soltaninejad K, Shadnia S (2018) Lead poisoning in opium abuser in Iran: a systematic review. Int J Prev Med 9:3CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Sveinsson O, Herrman L, Hietala MA (2017) Heroin-induced acute myelopathy with extreme high levels of CSF glial fibrillar acidic protein indicating a toxic effect on astrocytes. BMJ Case Rep.  https://doi.org/10.1136/bcr-2017-219903 CrossRefPubMedGoogle Scholar
  38. 38.
    Tuzun M, Tuzun D, Salan A et al (2002) Lead encephalopathy: CT and MR findings. J Comput Assist Tomogr 26:479–481CrossRefPubMedGoogle Scholar
  39. 39.
    Vitt JR, Brown EG, Chow DS et al (2017) Confirmed case of levamisole-associated multifocal inflammatory leukoencephalopathy in a cocaine user. J Neuroimmunol 305:128–130CrossRefPubMedGoogle Scholar
  40. 40.
    Walubo A, Seger D (1999) Fatal multi-organ failure after suicidal overdose with MDMA, ‘ecstasy’: case report and review of the literature. Hum Exp Toxicol 18:119–125PubMedGoogle Scholar
  41. 41.
    Wolff V, Jouanjus E (2017) Strokes are possible complications of cannabinoids use. Epilepsy Behav 70:355–363CrossRefPubMedGoogle Scholar
  42. 42.
    Yu YJ, Cooper DR, Wellenstein DE et al (1983) Cerebral angiitis and intracerebral hemorrhage associated with methamphetamine abuse. Case report. J Neurosurg 58:109–111CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Diagnostische und Interventionelle NeuroradiologieUniversitätsklinikum des SaarlandesHomburg/SaarDeutschland

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