Haemorrhagic stroke related to the use of 4-fluoroamphetamine.

Abstract

INTRODUCTION:

The use of the new psychoactive substance 4-fluoroamphetamine (4-FA) and the number of 4-FA-related intoxications substantially increased in The Netherlands in recent years. We describe two patients with severe 4-FA-related complications and the characteristics of a large sample of 4-FA-intoxicated patients.

METHODS:

Information on patients with 4-FA-related intoxications between January 2009 and June 2017 was available from the Monitor Drug-related Incidents. Detailed clinical information was obtained of two patients with haemorrhagic stroke after toxicologically confirmed 4-FA use.

RESULTS:

We report on two patients who presented with headache and mild hypertension after 4-FA use. Patient A developed one-sided weakness and decreased consciousness after a few hours. A computed tomography scan showed a left-sided intracerebral haemorrhage. Because of life-threatening cerebral herniation, haematoma evacuation was performed. Postoperatively, she suffered from a right-sided hemiparalysis and severe aphasia, requiring clinical rehabilitation. Patient B had a subarachnoid haemorrhage without neurological deficits. In total, 939 4-FA-intoxicated patients were registered. These patients used 4-FA alone (44%) or in combination with alcohol (13%) and/or other drugs (43%).

DISCUSSION:

Patients using 4-FA are at risk for life-threatening health problems, including intracranial haemorrhage. Additional brain imaging should be considered in 4-FA-intoxicated patients, not only in the presence of neurological deficits, but also in the case of severe headache.

• Authors: C H W Wijers, M C Visser, R T H van Litsenburg, R J M Niesink, R B Willemse, Esther A Croes
• Journal: Journal of neurology (J Neurol) Vol. 265 Issue 7 Pg. 1607-1611 (Jul 2018) ISSN: 1432-1459 [Electronic] Germany
• PMID: 29737425 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Amphetamines
• Illicit Drugs
• 4-fluoroamphetamine

Topics

• Adolescent
• Adult
• Amphetamines (adverse effects)
• Female
• Frontal Lobe (diagnostic imaging)
• Humans
• Illicit Drugs (adverse effects)
• Intracranial Hemorrhages (chemically induced, complications, diagnostic imaging, epidemiology)
• Male
• Retrospective Studies
• Stroke (chemically induced, complications, diagnostic imaging, epidemiology)
• Young Adult