title: A case of fatal hemorrhage in the cerebral ventricles following intravenous use of methamphetamine.
abstract: We describe a case of massive hemorrhage in the cerebral ventricles, probably caused by methamphetamine abuse. A 44-year-old male was found dead in a prone position in a hotel room. Old and new injection marks were observed in his right cubital fossa. Petechiae were observed on the conjunctiva of his right eye, laryngeal mucosa, epicardium and under the capsule of the liver (to a slight or moderate degree). The brain, weighing 1.67 kg, was heavily edematous; the lateral and fourth ventricles were filled with hematomas. Subarachnoid, intracerebral hemorrhages were not observed. Cerebral vascular abnormalities were not evident. There were no remarkable changes in other organs, other than congestion. Gas chromatographic-mass spectrometric analysis of the urine disclosed the presence of methamphetamine and amphetamine. The concentration of methamphetamine within the femoral venous blood and intraventricular hematoma was 0.347 microg/ml and 0.189 microg/g, respectively. Amphetamine was not detected in either sample. Urine contained 3.15 microg/ml methamphetamine and 0.063 microg/ml amphetamine. These results indicate that intraventricular hemorrhage might have occurred shortly after intravenous self-administration of methamphetamine. Cerebral arterial spasm and hypertension resulting from the administration of methamphetamine might have resulted in intraventricular hemorrhage.
authors.affiliation: Department of Legal Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku City, Japan. moriyaf@kochi-ms.ac.jp
authors.forename: Fumio
authors.initials: F
authors.lastname: Moriya
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hashimoto
mesh_terms: D000089:Acetic Anhydrides; D000328:Adult; D000661:Amphetamine / Q000009:adverse effects / Q000097:blood / Q000652:urine; D000697:Central Nervous System Stimulants / Q000009:adverse effects* / Q000097:blood / Q000652:urine; D002543:Cerebral Hemorrhage; D002552:Cerebral Ventricles / Q000187:drug effects*; D017809:Fatal Outcome; D005463:Fluoroacetates; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects* / Q000097:blood / Q000652:urine; D015819:Substance Abuse, Intravenous; D014269:Trifluoroacetic Acid / Q000652:urine
chemical_list: D000089:Acetic Anhydrides; D000697:Central Nervous System Stimulants; D005463:Fluoroacetates; D008694:Methamphetamine; C017958:trifluoroacetic anhydride; D000661:Amphetamine; D014269:Trifluoroacetic Acid