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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1811
REVIEW ARTICLE
Addictive Illegal Drugs: Structural Neuroimaging
From the Division of Neuroradiology (S.G.), Department of Diagnostic Radiology, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Neuroradiology (M.G.), University Hospital "S. Salvatore," L'Aquila, Italy; and Division of Neuroradiology (T.K.), Department of Medical Imaging, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.
Please address correspondence to T. Krings, MD, PhD, University of Toronto, Toronto Western Hospital, UHN, Division of Neuroradiology, 399 Bathurst St, 3MCL-429, Toronto, ON, M5T 2S8, Canada; e-mail: timo.krings{at}uhn.on.ca
SUMMARY: Illegal addictive drugs can lead to functional or structural impairment of the central nervous system. This review provides an overview of the structural imaging findings on CT, MR imaging, and conventional angiography related to chronic and acute abuse of the most commonly abused illegal drugs, including cannabis, organic solvents, and amphetamines and opioids and their respective derivatives. Pathomechanisms include excitotoxicity, which may lead to an acute or subacute leukoencephalopathy, and vascular complications, including vasoconstriction, vasculitis, or hypertension, which may lead to intracranial hemorrhage or ischemia. Because clinical findings alone are often nonspecific, and afflicted patients are unlikely to admit to the substance abuse, the neuroradiologist may play an important role in establishing the diagnosis and, thereby, initiating treatment.
Abbreviations: PET, positron-emission tomography