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Acute brain injury following illicit drug abuse in adolescent and young adult patients: spectrum of neuroimaging findings.

Abstract The use of illicit drugs is currently a major medical problem among adolescents. Several illicit drugs have a high abuse potential and can be neurotoxic causing high morbidity and mortality. The clinical manifestation of adolescents with acute drug-induced neurotoxicity is often characterized by non-specific symptoms and findings. Early diagnosis is important to prevent death and permanent long-term neurological impairments. We report on clinical and neuroimaging findings in five adolescents with acute brain imaging following illicit drug intoxication to highlight the role of neuroimaging findings in the diagnostic work-up of pediatric acute drug-induced neurotoxicity. Our patients reveal two main neuroimaging patterns of brain injury: diffuse symmetric subcortical white matter injury with preferential cerebellar involvement (leukoencephalopathy pattern) or multiple foci of ischemic infarctions in a non-arterial territory distribution (ischemic pattern). Familiarity with these two neuroimaging patterns of findings in the evaluation of magnetic resonance imaging studies in adolescents with acutely altered mental status may suggest the correct diagnosis, narrow the differential diagnosis, and consequently allow early initiation of targeted laboratory investigations and treatment, potentially improving outcome.
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Authors

Mayor MeshTerms
Keywords

Neurotoxicity

cocaine

heroin

leukoencephalopathy

Journal Title the neuroradiology journal
Publication Year Start




PMID- 28424016
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 2385-1996 (Electronic)
IS  - 1971-4009 (Linking)
VI  - 30
IP  - 2
DP  - 2017 Apr
TI  - Acute brain injury following illicit drug abuse in adolescent and young adult
      patients: spectrum of neuroimaging findings.
PG  - 144-150
LID - 10.1177/1971400917691994 [doi]
AB  - The use of illicit drugs is currently a major medical problem among adolescents. 
      Several illicit drugs have a high abuse potential and can be neurotoxic causing
      high morbidity and mortality. The clinical manifestation of adolescents with
      acute drug-induced neurotoxicity is often characterized by non-specific symptoms 
      and findings. Early diagnosis is important to prevent death and permanent
      long-term neurological impairments. We report on clinical and neuroimaging
      findings in five adolescents with acute brain imaging following illicit drug
      intoxication to highlight the role of neuroimaging findings in the diagnostic
      work-up of pediatric acute drug-induced neurotoxicity. Our patients reveal two
      main neuroimaging patterns of brain injury: diffuse symmetric subcortical white
      matter injury with preferential cerebellar involvement (leukoencephalopathy
      pattern) or multiple foci of ischemic infarctions in a non-arterial territory
      distribution (ischemic pattern). Familiarity with these two neuroimaging patterns
      of findings in the evaluation of magnetic resonance imaging studies in
      adolescents with acutely altered mental status may suggest the correct diagnosis,
      narrow the differential diagnosis, and consequently allow early initiation of
      targeted laboratory investigations and treatment, potentially improving outcome.
FAU - Shrot, Shai
AU  - Shrot S
AD  - 1 Department of Radiology and Radiological Science, Johns Hopkins Hospital, USA.
FAU - Poretti, Andrea
AU  - Poretti A
AD  - 1 Department of Radiology and Radiological Science, Johns Hopkins Hospital, USA.
FAU - Tucker, Elizabeth W
AU  - Tucker EW
AD  - 2 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins
      University School of Medicine, USA.
AD  - 3 Department of Anesthesiology and Critical Care Medicine, Johns Hopkins All
      Children's Hospital, USA.
FAU - Soares, Bruno P
AU  - Soares BP
AD  - 1 Department of Radiology and Radiological Science, Johns Hopkins Hospital, USA.
FAU - Huisman, Thierry Agm
AU  - Huisman TA
AD  - 1 Department of Radiology and Radiological Science, Johns Hopkins Hospital, USA.
LA  - eng
PT  - Journal Article
DEP - 20170101
PL  - United States
TA  - Neuroradiol J
JT  - The neuroradiology journal
JID - 101295103
SB  - IM
MH  - Adolescent
MH  - Brain Injuries/*diagnostic imaging/*etiology
MH  - Female
MH  - Humans
MH  - Image Processing, Computer-Assisted
MH  - Male
MH  - Neuroimaging/*methods
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Substance-Related Disorders/*complications
MH  - Young Adult
OTO - NOTNLM
OT  - Neurotoxicity
OT  - cocaine
OT  - heroin
OT  - leukoencephalopathy
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
AID - 10.1177/1971400917691994 [doi]
PST - ppublish
SO  - Neuroradiol J. 2017 Apr;30(2):144-150. doi: 10.1177/1971400917691994. Epub 2017
      Jan 1.

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