Korean J Leg Med.  2018 Aug;42(3):98-101. 10.7580/kjlm.2018.42.3.98.

A Fatal Intracerebral Hemorrhage due to Chronic Methamphetamine Use

• Na JY
• Kim JJ
• Park JT

• KMID: 2419460
• DOI: http://doi.org/10.7580/kjlm.2018.42.3.98

Abstract

The authors report a case of an otherwise healthy 33-year-old man who presented with intracerebral hemorrhage in the right frontal lobe following chronic methamphetamine use. An autopsy was performed within 2 days after death. The postmortem examination revealed cerebral edema and intracerebral and intraventricular hemorrhage. Microscopic examination revealed endovasculitis in the systemic vessels including the aorta and carotid and coronary arteries, but no aneurysm or arterio-venous malformation. Acute toxicity and chronic methamphetamine use was verified using blood and segmental hair analysis, respectively. Cerebrovascular accidents including stroke and intracerebral and subarachnoid hemorrhage are rare in young persons, but methamphetamine use is a risk factor for cerebrovascular accidents in young adults. Therefore, forensic pathologists should be aware of the acute and chronic harmful effects of methamphetamine. Detailed history taking and toxic screening tests for illicit drug use, especially methamphetamine, as well as a meticulous postmortem examination should be conducted in young patients who died due to cerebrovascular accident.

Keyword

Methamphetamine; Cerebral hemorrhage; Substance-related disorders; Autopsy

MeSH Terms

Adult
Aneurysm
Aorta
Autopsy
Brain Edema
Cerebral Hemorrhage*
Coronary Vessels
Frontal Lobe
Hair
Hemorrhage
Humans
Mass Screening
Methamphetamine*
Risk Factors
Stroke
Subarachnoid Hemorrhage
Substance-Related Disorders
Young Adult
Methamphetamine

Figure

• 

  Fig. 1. Intracerebral hemorrhage in the right frontal and intraventricular hemorrhage were noted.

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  Fig. 2. Microscopic examination verified the edema and chronic lymphocytic infiltration in the intima of the descending aorta (A) and carotid artery (B) (A and B, ×200) and thickening and infiltration of the lymphocyte in the intima of the left descending coronary artery (C) and right coronary artery (D) (C and D, × 100).

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  Fig. 3. Methamphetamine is detected in the three segments of the hair.

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