1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-14-68-a 10.15844/pedneurbriefs-14-9-6 Toxic-Metabolic Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Amphetamine Abuse and Intracranial Hemorrhage http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 09 2000 01 04 2016 14 9 68 68 Copyright: © 2000 The Author(s) 2000 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Amphetamine abuse and intracranial haemorrhage

Eight young adults presenting with intracranial hemorrhage at the Department of Neurosurgery, Queen’s Medical Center and University Hospital, Nottingham, UK, in a 3 and 1/2 year period, were diagnosed with amphetamine abuse.

 Amphetamine Abuse Intracranial Hemorrhage Cerebral Digital Subtraction Angiography

Eight young adults presenting with intracranial hemorrhage at the Department of Neurosurgery, Queen’s Medical Center and University Hospital, Nottingham, UK, in a 3 and 1/2 year period, were diagnosed with amphetamine abuse. The time from amphetamine exposure to onset of symptoms ranged from 10 minutes to 2 months (median within 24 hours). CT and cerebral digital subtraction angiography (DSA) showed a parenchymal hematoma in 7 (3 in the frontal lobe), and a subarachnoid hemorrhage in 1. Beading of small and medium-sized arteries, characteristic of vasculitis, also occurred in 1. Four recovered, but 1 died and 3 were hemiplegic.

Of 37 previously reported cases, from 1945 to 1996, 6 died and 17 had hemiparesis. One-third claimed to be infrequent amphetamine users. The first reported death from amphetamine abuse (JAMA 1939) was in a 25 year-old man who had taken the drug as a stimulant before a college examination. Amphetamine use or abuse should be considered in diagnosis of a frontal or parietal lobe hematoma in a young patient. [1]

COMMENT. Amphetamines taken orally, IV, or rarely, inhaled, have resulted in cerebral vasculitis and intracranial hemorrhage. Unfortunately, the dosages involved are unknown. The outcome is poor in more than half the cases reported. Vasculitis, that can follow only a single exposure to oral amphetamines, is characterized by irregular segmental narrowing or beading of small cerebral arteries.

Perhaps the recent increased popularity of amphetamine drugs in the treatment of ADHD in school-age children should be reappraised.

Buxton N McConachie NS Amphetamine abuse and intracranial haemorrhage J R Soc Med 2000 Sep 93 9 472 477 11089483