Chasing the dragon: heroin smoking related toxic leukoencephalopathy

Case contributed by A.Prof Frank Gaillard

Presentation

Homeless adult with altered cognition.

Patient Data

Age: Young adult

Prominent T2 high signal with some minor swelling is seen involving the white matter particularly of the cerebellar hemispheres as well as posterior limb of internal capsule, extending up to to the subcortical perirolandic cortex. Occipital poles are also affected. 

1 year later T2 signal abnormality is still prominant. 

A repeat MRI performed 3 years after presentation demonstrates significant loss of volume in particularly in the regions of previous high T2 signal with reduction in the degree of abnormal signal. 

Case Discussion

This patient had an extensive known history of heroin smoking, known colloquially as chasing the dragon. These are characteristic features. 

PlayAdd to Share

Case information

rID: 4443
Published: 25th Aug 2008
Last edited: 23rd Oct 2018
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.