December 27, 2006 (Irvine, CA) - Methamphetamine use may be linked to increased risk of carotid artery dissection and stroke, according to an article published in the December 26, 2006 issue of Neurology [ 1].
"It appears methamphetamine use is toxic to large blood vessels,” said Dr Wengui Yu (University of California, Irvine). "While methamphetamine use has been associated with aortic dissection . . . this is the first time there's been a possible link between methamphetamine use and carotid artery dissection."
The article reported the cases of two women, ages 36 and 29, who suffered sudden onset of speech difficulty and weakness following recent use of methamphetamine. The 29-year-old had a ten-year history of methamphetamine use. Yu acknowledged that cocaine has similar effects. "It’s therefore likely that the tears in the arteries may be due to a drug class effect rather than a specific drug, like methamphetamine."
MRI confirmed both women had severe strokes due to carotid artery dissection. The 36-year-old woman had a National Institute of Health Stroke Scale (NIHSS) of 21 (a stroke scale over 16 predicts a high probability of death or severe disability). She was treated quickly with IV tissue plasminogen activator (tPA) and improved significantly, returning to work within four months with only mild expressive aphasia. The 29-year-old woman had an NIHSS score of 17. She was treated with stent-assisted angioplasty and had moderate expressive aphasia at four months. Follow-up angiography at seven months showed no restenosis.
Yu credited timely evaluation and treatment by a multidisciplinary stroke team with the almost complete recovery of the subjects, and not the youth of the subjects themselves. "Without effective acute treatment, patients would be less likely to have good recovery."
A prospective multi-center study of young adults with stroke is warranted to further investigate the association between methamphetamine/cocaine use and neck artery dissection, the authors write. "The results of such study will not only address the drug class effect but also help physicians to better diagnose, treat, and prevent stroke in young adults," said Yu.
Yu W, McIntosh A, Hungs M, et al. Carotid artery dissection and middle cerebral artery stroke following methamphetamine use. Neurology 2006; 67:2259-2260.
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Cite this: Erica Patino. Methamphetamine Use Increases Risk of Carotid Artery Dissection and Stroke - Medscape - Dec 27, 2006.