Neurologic complications following intranasal administration of heroin in an adolescent.
OBJECTIVE
To describe an adolescent patient who developed a stroke following intranasal administration of heroin.


METHODS
A 17-year-old adolescent with no prior medical problems "snorted" an unknown quantity of heroin. The patient developed respiratory failure, shock, and seizures. When he regained consciousness, the patient had evidence of hypoxic-toxic encephalopathy on neuropsychologic examination. Magnetic resonance imaging revealed an infarct in the globus pallidus region of the brain.


CONCLUSIONS
Serious neurologic complications following intranasal administration of heroin have been reported rarely in children. Correlations between findings on neuropsychologic examination and magnetic resonance imaging following drug overdoses have likewise been rarely described. We reviewed literature pertaining to the etiology, pharmacology, and pathophysiology of neurologic complications resulting from heroin intoxication.


CONCLUSIONS
As the use of intranasal heroin is increasing in the pediatric population, healthcare professionals should be aware of the various potentially serious complications that may occur.
Zuckerman
G B
GB
Department of Pediatrics, University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School (RWJMS), New Brunswick 08903, USA.
Ruiz
D C
DC
Keller
I A
IA
Brooks
J
J
D000281:Administration, Intranasal; D000293:Adolescent; D002544:Cerebral Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D004298:Dopamine / Q000008:administration & dosage; D005260:Female; D006501:Hepatic Encephalopathy / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D003932:Heroin / Q000009:adverse effects*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008140:Lorazepam / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D019966:Substance-Related Disorders / Q000150:complications*
D006993:Hypnotics and Sedatives; D003932:Heroin; D008140:Lorazepam; D004298:Dopamine