Historique
Article de Périodique
The incidence of acute cocaine or methamphetamine intoxication in deaths due to ruptured cerebral aneurysms (1996)
(Incidence de l'intoxication par la cocaïne ou la métamphétamine sur les décès dus à une rupture d'anévrisme)
Auteur(s) :
DAVIS, G. G. ;
SWALWELL C. I.
Année
1996
Page(s) :
626-628
Langue(s) :
Anglais
Refs biblio. :
16
Domaine :
Drogues illicites / Illicit drugs
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus mots-clés
COCAINE
;
CERVEAU
;
PATHOLOGIE
;
MEDECINE LEGALE
;
ANEVRISME
;
METHAMPHETAMINE
;
INTOXICATION
;
MORTALITE
Résumé :
FRANÇAIS :
La cocaïne et la méthamphétamine entrainent une hypertension et une tachycardie qui peuvent être responsables de l'aggravation et de la rupture d'anévrisme au niveau du cerveau. L'étude de 83 cas de rupture d'anévrisme, dont 13 chez des usagers de drogues, montrent une incidence élevée pour la cocaïne et la méthamphétamine, plus élevée pour la méthamphétamine que pour la cocaïne, peut-être en raison de sa demi-vie plus longue.
ENGLISH :
Acute intoxication with either cocaine or methamphetamine may contribute to formation and rupture of a berry aneurysm by causing transient hypertension and tachycardia. We report the results of a retrospective study to determine the incidence of acute cocaine or methamphetamine intoxication in deaths due to ruptured berry aneurysm in our jurisdictions. We reviewed all deaths from ruptured cerebral aneurysms that fell within our jurisdictions during the seven years from 1 January 1987 to 31 December 1993 and found 83 cases. The mechanism of death invariably involved subarachnoid hemorrhage, although some cases also had intracerebral hemorrhage. A history of drug abuse was found in 13 cases. Toxicological analysis was performed in 39 cases. Of these methamphetamine was detected in six cases and cocaine in three cases--an incidence of 21%. (In one case both methamphetamine and cocaine were detected.) The incidence of acute cocaine intoxication in all autopsies in Jefferson County was 13.6%. The incidence of methamphetamine intoxication in all autopsies in San Diego County was 4.9%.
Although the exact mechanism by which berry anearysms form remains undetermined, research indicates that propagation and rupture of the aneurysm are aggravated by hypertension and tachycardia, both of which are pharmacologic side effects of cocaine and methamphetamine. Based on the preponderance of methamphetamine associated with deaths due to ruptured berry aneurysms it appears that methamphetamine is more toxic than cocaine, perhaps owing to the longer half-life of methamphetamine.
La cocaïne et la méthamphétamine entrainent une hypertension et une tachycardie qui peuvent être responsables de l'aggravation et de la rupture d'anévrisme au niveau du cerveau. L'étude de 83 cas de rupture d'anévrisme, dont 13 chez des usagers de drogues, montrent une incidence élevée pour la cocaïne et la méthamphétamine, plus élevée pour la méthamphétamine que pour la cocaïne, peut-être en raison de sa demi-vie plus longue.
ENGLISH :
Acute intoxication with either cocaine or methamphetamine may contribute to formation and rupture of a berry aneurysm by causing transient hypertension and tachycardia. We report the results of a retrospective study to determine the incidence of acute cocaine or methamphetamine intoxication in deaths due to ruptured berry aneurysm in our jurisdictions. We reviewed all deaths from ruptured cerebral aneurysms that fell within our jurisdictions during the seven years from 1 January 1987 to 31 December 1993 and found 83 cases. The mechanism of death invariably involved subarachnoid hemorrhage, although some cases also had intracerebral hemorrhage. A history of drug abuse was found in 13 cases. Toxicological analysis was performed in 39 cases. Of these methamphetamine was detected in six cases and cocaine in three cases--an incidence of 21%. (In one case both methamphetamine and cocaine were detected.) The incidence of acute cocaine intoxication in all autopsies in Jefferson County was 13.6%. The incidence of methamphetamine intoxication in all autopsies in San Diego County was 4.9%.
Although the exact mechanism by which berry anearysms form remains undetermined, research indicates that propagation and rupture of the aneurysm are aggravated by hypertension and tachycardia, both of which are pharmacologic side effects of cocaine and methamphetamine. Based on the preponderance of methamphetamine associated with deaths due to ruptured berry aneurysms it appears that methamphetamine is more toxic than cocaine, perhaps owing to the longer half-life of methamphetamine.
Affiliation :
Jefferson County Coroner, Birmingham, AL, USA