title: Heroin inhalation-induced unilateral complete hippocampal stroke.
abstract: A 33-year-old man presented to our clinic with amnesia 48 hours after his first heroin inhalation. Examination showed lateral tongue biting and anterograde amnesia demonstrated by impaired performance on verbal and visual Wechsler Memory Scale-Revised tests carried out 10 days after onset, suggesting hippocampal involvement. Magnetic resonance imaging (MRI) of the brain was performed 48 hours after heroin snorting and evoked cortical laminar necrosis (CLN) of the left hippocampus without vascular abnormality. This is the first description of complete hippocampal CLN as a complication subsequent to acute intranasal heroine abuse. While the pathogenic mechanism remains uncertain, our case provides a very specific MRI lesion pattern and highlights the risk of intranasal heroin uptake-induced neurological complication.
authors.affiliation: Department of Neurology, Strasbourg University Hospital, Strasbourg, France. aurelienbenoilid@gmail.com
authors.forename: Aurélien
authors.initials: A
authors.lastname: Benoilid
authors.forename: Nicolas
authors.initials: N
authors.lastname: Collongues
authors.forename: Jérôme
authors.initials: J
authors.lastname: de Seze
authors.forename: Fréderic
authors.initials: F
authors.lastname: Blanc
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D000647:Amnesia / Q000150:complications; D007839:Functional Laterality / Q000502:physiology*; D003932:Heroin / Q000009:adverse effects*; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008297:Male; D009294:Narcotics / Q000009:adverse effects*; D009483:Neuropsychological Tests; D020521:Stroke / Q000139:chemically induced* / Q000150:complications / Q000473:pathology*
chemical_list: D009294:Narcotics; D003932:Heroin