“Chasing-the-Dragon” – Toxic Leukoencephalopathy. A Case Report
Toxic leukoencephalopathy occurs as a result of exposure to a wide variety of drugs such as cocaine, ethanol, 3,4-ethylenedioxymethamphetamine, intravenous heroin, psilocybin, toluene as well as inhaled heroin pyrolysate. The leukoencephalopathy caused by inhaled heroin called “chasing the dragon” results in characteristic signal abnormalities on MRI but may present similarities to other toxic leukoencephalopathies as well. We present a case of heroin vapour abuse with a cerebral MRI presenting symmetrical T2 hyperintensities in both of the temporal lobes, the centrum semiovale, the right occipital lobe, and the splenium of the corpus callosum, with restricted diffusion. The MRI findings quickly improved and the patient gradually recovered.
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