TY - JOUR
T1 - Haemorrhagic stroke related to the use of 4-fluoroamphetamine
AU - Wijers, C. H. W.
AU - Visser, M. C.
AU - van Litsenburg, R. T. H.
AU - Niesink, R. J. M.
AU - Willemse, R. B.
AU - Croes, Esther A.
PY - 2018
Y1 - 2018
N2 - Introduction: The use of the new psychoactive substance 4-fluoroamphetamine (4-FA) and the number of 4-FA-related intoxications substantially increased in The Netherlands in recent years. We describe two patients with severe 4-FA-related complications and the characteristics of a large sample of 4-FA-intoxicated patients. Methods: Information on patients with 4-FA-related intoxications between January 2009 and June 2017 was available from the Monitor Drug-related Incidents. Detailed clinical information was obtained of two patients with haemorrhagic stroke after toxicologically confirmed 4-FA use. Results: We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in combination with alcohol (13%) and/or other drugs (43%). Discussion: Patients using 4-FA are at risk for life-threatening health problems, including intracranial haemorrhage. Additional brain imaging should be considered in 4-FA-intoxicated patients, not only in the presence of neurological deficits, but also in the case of severe headache.
AB - Introduction: The use of the new psychoactive substance 4-fluoroamphetamine (4-FA) and the number of 4-FA-related intoxications substantially increased in The Netherlands in recent years. We describe two patients with severe 4-FA-related complications and the characteristics of a large sample of 4-FA-intoxicated patients. Methods: Information on patients with 4-FA-related intoxications between January 2009 and June 2017 was available from the Monitor Drug-related Incidents. Detailed clinical information was obtained of two patients with haemorrhagic stroke after toxicologically confirmed 4-FA use. Results: We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in combination with alcohol (13%) and/or other drugs (43%). Discussion: Patients using 4-FA are at risk for life-threatening health problems, including intracranial haemorrhage. Additional brain imaging should be considered in 4-FA-intoxicated patients, not only in the presence of neurological deficits, but also in the case of severe headache.
KW - Adolescent
KW - Adult
KW - Amphetamines/adverse effects
KW - Female
KW - Frontal Lobe/diagnostic imaging
KW - Humans
KW - Intracranial Hemorrhages/chemically induced
KW - Male
KW - Retrospective Studies
KW - Street Drugs/adverse effects
KW - Stroke/chemically induced
KW - Young Adult
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046674611&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29737425
U2 - https://doi.org/10.1007/s00415-018-8888-6
DO - https://doi.org/10.1007/s00415-018-8888-6
M3 - Article
C2 - 29737425
SN - 0340-5354
VL - 265
SP - 1607
EP - 1611
JO - Journal of neurology
JF - Journal of neurology
IS - 7
ER -