Clinical Neurology and Neurosurgery
Volume 111, Issue 3 , Pages 278-281, April 2009

Hippocampal involvement due to heroin inhalation—“Chasing the Dragon”

  • Praveen K. Gupta

      Affiliations

    • Department of Clinical Neurosciences, Salmania Medical Complex, Manama, Bahrain
    • Corresponding Author InformationCorresponding author at: Flat 12, Bldg 695, Road 1123, Salmania, Block 311, Manama, Bahrain. Tel.: +973 17 276112/391 70807; fax: +973 284372.
    • ,
  • P.R. Krishnan

      Affiliations

    • Department of Clinical Neurosciences, Salmania Medical Complex, Manama, Bahrain
    • ,
  • P.J. Sudhakar

      Affiliations

    • Department of Radiology, Salmania Medical Complex, Manama, Bahrain

Received 18 May 2008; received in revised form 1 September 2008; accepted 5 September 2008.

Abstract 

Toxic leukoencephalopathy occurs as a result of exposure to wide variety of agents. Inhalation of heroin or its vapours produces a distinct syndrome with characteristic findings on MR imaging. We report a case of heroin vapour abuse (chasing the dragon) who presented with altered sensorium. MRI of the brain showed symmetrical T2 hyperintensities over the cerebellum and hippocampi. The patient gradually improved and made good recovery but developed spasticity of all the limbs due to delayed involvement of bilateral basal ganglia. This is the first report of bilateral hippocampal involvement in a patient abusing heroin vapour.

Keywords: Hippocampus, Heroin toxicity, Chasing the dragon, Toxic leukoencephalopathy

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PII: S0303-8467(08)00316-8

doi:10.1016/j.clineuro.2008.09.004

Clinical Neurology and Neurosurgery
Volume 111, Issue 3 , Pages 278-281, April 2009

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