ArticleJournal of the Intensive Care Society2019
Chasing the wrong dragon: A new presentation of heroin-induced toxic leukoencephalopathy mimicking anoxic brain injury.
Article in Journal of the Intensive Care Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Neurocognitive impairments and brain abnormalities resulting from opioid-related overdoses: A systematic review.Drug and alcohol dependence · 2021Pooled it
- Construction and validation of a predictive nomogram for 28-day mortality in critically ill patients with toxic encephalopathy.BMC medical informatics and decision making · 2026Article
- Morbidity, mortality, and health outcomes following emergency department visits for fentanyl-related overdoses: A retrospective cohort study.Drug and alcohol dependence reports · 2026Article
- The dangers of "Chasing the dragon": a fatal case of heroin-induced leukoencephalopathy.BJR case reports · 2024Article
- Association between toxic drug events and encephalopathy in British Columbia, Canada: a cross-sectional analysis.Substance abuse treatment, prevention, and policy · 2023Article
- Neuropsychological, neuroimaging and autopsy findings of butane encephalopathy.BMC neurology · 2023Article
- Spongiform leukoencephalopathy unveiled in an autopsy of a drug abuser.Autopsy & case reports · 2023Article
- Prognosis in substance abuse-related acute toxic leukoencephalopathy: A scoping review.Journal of the neurological sciences · 2022Article
- Inflammatory Markers in Substance Use and Mood Disorders: A Neuroimaging Perspective.Frontiers in psychiatry · 2022Review
- Chasing the dragon and stumbling upon an octopus: A case of heroin-induced leukoencephalopathy and reverse takotsubo cardiomyopathy.Annals of medicine and surgery (2012) · 2021Article
- Spongiform leukoencephalopathy: A unique case of biopsy confirmed leukoencephalopathy secondary to toxic, non-inflammatory exposure.SAGE open medical case reports · 2021Article
- An Atypical Presentation of Heroin Inhalation Induced Leukoencephalopathy (Chasing the Dragon).Cureus · 2020Article
- Malignant cerebellar edema in three-year-old girl following accidental opioid ingestion and fentanyl administration.The neuroradiology journal · 2019Article
- Toxic Leukoencephalopathy due to Inhalational Heroin Abuse.Annals of Indian Academy of NeurologyArticle
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Toxic leukoencephalopathy associated with heroin inhalation has been extensively described in the literature. This syndrome is characterized by progressive motor symptoms and dysautonomia that develop over weeks to months. We present three cases of abrupt-onset inhaled heroin-associated toxic leukoencephalopathy, a previously undescribed entity. These likely represent a subset of "found down" patients with acute neurologic changes not attributable to hypoxemic encephalopathy. All three had magnetic resonance imaging findings characteristic of toxic leukoencephalopathy, which has a relatively favorable prognosis. Prolonged unresponsiveness in patients "found down" after heroin overdose is often attributed to hypoxic brain injury. Brain magnetic resonance imaging is not generally included as part of routine workup. It should, however, be considered in patients with suspected inhaled heroin use due to the relatively favorable prognosis of toxic leukoencephalopathy. This is especially relevant in the setting of the current opioid epidemic and related increase in overdose-related intensive care unit admissions. The result may have significant impact on decisions about therapeutic options or continuation of care.
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