The occurrence of pallidal lesions with or without other hypoxic/ischaemic
brain injuries was evaluated in 100 intravenous (i.v.) heroin addicts. The
brains were collected consecutively from forensic autopsies during the peri
od from January 1995 to June 1996. The autopsies were required by the polic
e and performed at The Institute of Forensic Medicine, The National Hospita
l, Oslo. There were 21 women and 79 men, median age 32 (range 21-47) and 34
(19-60) years, respectively. Of 38 brains with abnormalities, twenty-five
cases showed isolated or combined lesions of hypoxic/ischaemic origin. Pall
idal lesions were found in nine brains; six lesions were old, one was subac
ute (a couple of weeks), and two were part of recent, generalized hypoxia/i
schaemia. Six persons had old infarcts in the hippocampal formation, and on
e of them in combination with old pallidal infarcts. In seven brains small
and old infarcts were found in watershed areas in the cerebellum. Between f
ive and ten percent of i.v. heroin addicts might have pallidal infarcts, ei
ther as the sole lesion, or combined with other manifestations of hypoxic/i
schaemic brain injury. This might give severe mental disturbances in the af
fected persons. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.