Two cases of cerebrovascular disease related to methamphetamine abuse

Abstract

Background: We herein report two cases of cerebrovascular disease following methamphetamine abuse. Case 1: A 36-year-old man with a history of methamphetamine abuse for several years suddenly experienced weakness of the right upper and lower limbs shortly after inhalation of methamphetamine. The patient was transported to the emergency department in a comatose state. Computed tomography was performed and revealed a massive hematoma in the left cerebral hemisphere. He had a cardiopulmonary arrest 3 h after admission and died 69 days later. Case 2: A 57-year-old man had been a methamphetamine addict since he was in his twenties. He started complaining of general malaise and difficulty in moving after intravenous injection of methamphetamine. Two days later, the patient was hospitalized for altered state of consciousness with a temperature of 38.7°C. Urine analysis using the triage system showed positive reaction for amphetamines. Magnetic resonance imaging revealed multiple cerebral infarcts in the thalamus, brainstem, and bilateral cerebellar hemispheres. A diagnosis of sepsis and cerebral infarction due to bacterial embolus was made, and antibiotic treatment was initiated. However, his general condition gradually deteriorated, and he died 10 days after admission. Conclusions: It is necessary to consider methamphetamine abuse as a cause of cerebrovascular disease in young adults with no underlying diseases such as hypertension and diabetes mellitus.