1/164. Severe panarteritis associated with drug abuse.A case of panarteritis with purpura fulminans, mononeuritis multiplex, gastrointestinal manifestation and presumably cardiac involvement in a previously healthy 22-year-old man with a history of drug abuse including cocaine, cannabinoids and methamphetamines is described. Histopathological examination of the gut led to the diagnosis of panarteritis without immune deposits. Antineutrophil antibodies were negative. Besides the drugs, no other possible cause of vasculitis was found. The patient recovered completely after 1 year. Drug abuse is a thus possible cause of severe extracerebral disabling vasculitis.- - - - - - - - - - ranking = 1keywords = cerebral (Clic here for more details about this article) |
2/164. Massive intracerebral hemorrhage in an amphetamine addict.A case of massive intracerebral hemorrhage, a rare but often fatal complication of amphetamine abuse, is described along with the review of the literature. There has been resurgence in the abuse of amphetamine. amphetamine or other illicit drug abuse should be considered in young patients with cerebrovascular events.- - - - - - - - - - ranking = 11.775972603238keywords = intracerebral, cerebral (Clic here for more details about this article) |
3/164. Subacute onset of oculogyric crises and generalized dystonia following intranasal administration of heroin.A case is reported of a patient who experienced sudden onset of severe respiratory failure, shock and coma after first-time intranasal heroin abuse. During the following days full consciousness was restored, revealing persistent oculogyric crises, axial retropulsive dystonia and ataxia. Initially computer tomography (CT) scans of the brain were normal and cerebral spinal fluid examination showed a slight elevation of lactate. magnetic resonance imaging (MRI) scans of the brain demonstrated diffuse bilateral subcortical white matter hyperintensities, with sparing of the U-fibers, symmetric bilateral hyperintensities of the globus pallidum and very hyperintensive subcortical foci in the right hemisphere. Differential diagnostic assessment, treatment, clinical and MRI course of a 6-month follow-up are discussed.- - - - - - - - - - ranking = 1.0798944649156keywords = cerebral, brain (Clic here for more details about this article) |
4/164. death due to inhalation of ethyl chloride.A 30-year-old white male was found dead in a locked apartment with a rag held loosely in his mouth. Four cans (3 empty, 1 partially empty) containing ethyl chloride and labeled as VCR head cleaner were found next to the body. phenylpropanolamine and low therapeutic levels of diazepam (64 microg/L) and nordiazepam (126 microg/L) were detected during toxicological analysis. An unidentified peak was observed when performing ethanol analysis by headspace gas chromatography. The peak was identified as ethyl chloride and the concentrations in the blood, urine, vitreous, brain, and lungs of the deceased were 423 mg/L, 35 mg/L, 12 mg/L, 858 mg/kg, and 86 mg/kg, respectively. The results were compared with previously reported levels of ethyl chloride in blood and vitreous and, based on a literature search, we believe that this is the first report of ethyl chloride levels in tissue.- - - - - - - - - - ranking = 0.039947232457785keywords = brain (Clic here for more details about this article) |
5/164. Cerebellar dysfunction in chronic toluene abuse: beneficial response to amantadine hydrochloride.CASE REPORT: A 21-year-old man who had sniffed toluene since the age of 13 presented with a 4-year history of progressive cerebellar dysfunction and visual deterioration. The patient's condition did not improve despite 5 months of abstinence. magnetic resonance imaging revealed cerebral atrophy and hypointensity signals in the white matter and bilaterally in the globus pallidus, thalamus, red nucleus, and substantia nigra. amantadine hydrochloride therapy (100 mg/d, then 200 mg/d) resulted in dramatic improvement of his cerebellar and visual symptoms.- - - - - - - - - - ranking = 1keywords = cerebral (Clic here for more details about this article) |
6/164. Drug-induced and traumatic nail problems in the haemophilias.Many persons with haemophilia suffer from hiv and receive highly active antiretroviral therapy. Three patients received indinavir and required surgery due to ingrown toenails. Two patients suffered from a traumatic subungual haematoma. The treatment protocol is described whereby the pressure exerted onto the germinal layer and the nail bed is relieved in order to alleviate pain and nail matrix damage.- - - - - - - - - - ranking = 0.019828826983023keywords = haematoma (Clic here for more details about this article) |
7/164. naltrexone treatment of dementia with severe self-injurious behaviors: a single case study.The results of studies of the opiate antagonist naltrexone (NLTX) in the treatment of self-injurious behavior (SIB) in various psychiatric populations have been equivocal. The majority of studies has relied on small samples, many of which lacked scientific rigor and none of which occurred in a nursing facility. The present study investigates the use of NLTX on a patient with severe SIB who resides in a nursing facility. The patient is a 38-year-old male with a history of heavy drug and alcohol abuse. He has been in either a state hospital or nursing facility since age 21. The patient overdosed on alcohol and drugs in 1990, which led to a prolonged coma with organic brain damage.- - - - - - - - - - ranking = 0.039947232457785keywords = brain (Clic here for more details about this article) |
8/164. Drug dreams: a neuropsychoanalytic hypothesis.Recent studies have shown that the ventral tegmental pathway stimulates both dreaming and drug craving. To investigate a possible clinical link between these two psychic phenomena, psychotherapy notes from the first six months of an addicted patient's treatment were reviewed, together with verbatim notes from the four years of psychoanalysis that followed. Of 240 dreams reported by the patient,58 had manifest content involving the seeking or using of drugs. There was no particular temporal or emotional thematic pattern to these "drug dreams,"which persisted through four and a half years of sobriety. Drug dreams are observable phenomena that reflect both the innate structure of the brain and neural changes produced by exposure to addictive drugs. In some addicted persons, exposure to drugs produces a fixed change in neurological functioning with which they must contend for years, possibly the rest of their lives. Drug craving meets Freud's defining characteristics for a drive: it is a constant pressure, originating from within the organism, to do work, and it constantly demands satisfaction. Because ego and libidinal drives share a common neural pathway, they should not be separated conceptually. Solms's finding (in press) that the activating systems for dreaming and for craving are identical, a finding based on observations of tumor- or stroke-provoked brain lesions, is confirmed by observation of the dreams of a patient whose brain changes were created by drug exposure. This study provides further evidence that the origin of the dream is a wish.- - - - - - - - - - ranking = 0.11984169737336keywords = brain (Clic here for more details about this article) |
9/164. Acute lead poisoning: Five cases resulting from self-injection of lead and opium.Five cases of acute lead poisoning resulted from the self-injection of lead and opium pills which were crushed, heated and suspended in water. Two of the five patients died of illnesses in which hepatic failure and reversible acute tubular necrosis were prominent features. One of these two had a severe neuropathy, with flaccid quadriplegia and respiratory paralysis. The other three patients had relatively minor symptoms but unequivocal biochemical evidence of lead toxicity. autopsy changes included hepatic degeneration with inclusion bodies, regenerating renal tubular epithelium and wasting of skeletal muscle. Hepatic lead content was extremely high in one case. chelation therapy in the other fatal case resulted in a fall in blood lead to within normal limits and a clinical improvement, which was terminated by massive haemorrhage from a ruptured innominate artery.- - - - - - - - - - ranking = 2.1884864355969keywords = haemorrhage (Clic here for more details about this article) |
10/164. Ten years of "body packers" in new york city: 50 deaths.We reviewed all 50 body packer deaths in new york city from 1990 to 2001. The majority (37/50) of deaths were caused by acute intoxications due to open or leaking drug packets in the gastrointestinal tract. The number of packets recovered ranged from 1 to 111 (average 46). The weight of the combined packets ranged from 9.4 to 1,200 g (average of 377). The age ranged from 19 to 57 years (mean 37.1). The decedents were: 82% male, 66% Hispanic, 24% Black, and 10% White. The manners of death were 47 accidents, 1 homicide, 1 natural, and 1 undetermined. The causes of death included 42 acute intoxications, 5 intestinal obstructions/bowel perforations, 1 gunshot wound, 1 intracerebral hemorrhage due to hypertensive disease, and 1 undetermined. Of the 50 decedents, 42 were transporting opiates, 4 cocaine, and 4 both opiates and cocaine. There were 9 deaths from 1990-1995 and 41 from 1996-2001. Of the 41 deaths between 1996 and 2001, only 6 involved cocaine. In new york city there has been an increase in body packer deaths from the early 1990s to the late 1990s. Along with this increase is a marked predominance of opiate body packer deaths with few cocaine deaths.- - - - - - - - - - ranking = 2.3551945206476keywords = intracerebral, cerebral (Clic here for more details about this article) |
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