title: Toxic spongiform leucoencephalopathy after inhaling heroin vapour.
abstract: This is a report of clinical, CT and MRI findings in a patient with toxic spongiform leucoencephalopathy after heroin ingestion. The disease is observed in drug addicts who inhale pre-heated heroin. The clinical onset, which usually occurs some days or even longer after the last heroin consumption, is characterized by a cerebellar syndrome. The cerebellar hemispheres, the cerebellar and cerebral peduncles and the pyramidal tract may be affected. Spongiform demyelination is the morphological substrate of the lesions, which are not contrast enhancing, hypodense on CT and hyperintense on T2-weighted MRI. The frequently perfect symmetry of the affection of functional systems points to a toxic and/or metabolic pathophysiological mechanism.
authors.affiliation: Klinik für Allgemeine Röntgendiagnostik und Neuroradiologie, Alfried-Krupp-Krankenhaus, Alfried Krupp Strasse 21, D-45117, Essen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.forename: H
authors.initials: H
authors.lastname: Henkes
authors.forename: P
authors.initials: P
authors.lastname: Möller
authors.forename: K
authors.initials: K
authors.lastname: Bade
authors.forename: D
authors.initials: D
authors.lastname: Kühne
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D017825:Canavan Disease / Q000139:chemically induced* / Q000175:diagnosis; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects*; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014835:Volatilization
chemical_list: D009294:Narcotics; D003932:Heroin