TOXIC SPONGIFORM LEUKOENCEPHALOPATHY AFTER INHALING HEROIN VAPOR

This is a report of clinical, CT and MRI findings in a patient with to xic spongiform leucoencephalopathy after heroin ingestion. The disease is observed in drug addicts who inhale pre-heated heroin. The clinica l onset, which usually occurs some days or even longer after the last heroin consumption, is characterized by a cerebellar syndrome. The cer ebellar hemispheres, the cerebellar and cerebral peduncles and the pyr amidal tract may be affected. Spongiform demyelination is the morpholo gical substrate of the lesions, which art: not contrast enhancing, hyp odense on CT and hyperintense on T2-weighted MRI. The frequently pet-f eet symmetry of the affection of functional systems points to a toxic and/or metabolic pathophysiological mechanism.