STROKE ASSOCIATED WITH METHAMPHETAMINE INHALATION

Seven patients (all men, mean age 32 years, range 17-47) with stroke f ollowing methamphetamine inhalation were collected during the last 2 y ears. Like oral or intravenous abusers, our patients had more hemorrha gic (n = 5) than ischemic strokes (n = 2). Cases of intracerebral hemo rrhage (ICH) were lobar (n = 3), caudate (n = 1) or putaminal (n = 1), whereas the infarctions were both in the middle cerebral artery regio n. Each stroke event occurred within 3 days after drug use. Three pati ents had hypertension on admission. Though young in age, most patients had multiple stroke risk factors. In 3 patients with ICH, we also fou nd small, low attenuated lesions on the brain computed tomography, how ever, without clinical correlations. Except for arteriovenous malforma tion in 1 patient, all angiograms failed to show vasculopathy or vasos pasm. Contrary to what one might surmise from previously published rep orts, methamphetamine inhalation is at least as likely to produce ICH as it is to produce brain infarction.