Posterior spinal artery aneurysm rupture after 'Ecstasy' abuse.
Jeremiah Johnson, Shnehal Patel, Efrat Saraf-Lavi, Mohammad Ali Aziz-Sultan, Dileep R Yavagal
Journal of neurointerventional surgery July 2015 DOI: 10.1136/neurintsurg-2014-011248.rep (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A teenager who ingested 'Ecstasy' |
| Topics | MDMA |
| Keywords | Aneurysm Drug Inflammation Spinal cord Spine |
| Key findings | The authors report a teenager who developed subarachnoid hemorrhage from a 2 mm left posterior spinal artery fusiform aneurysm after ingesting 'Ecstasy', with the aneurysm surgically excised and no postoperative neurological sequelae. They suggest 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, subarachnoid hemorrhage, and potentially de novo aneurysm formation and rupture. |
Abstract
Posterior spinal artery (PSA) aneurysms are a rare cause of subarachnoid hemorrhage (SAH). The commonly abused street drug 3,4-methylenedioxymethamphetamine (MDMA) or 'Ecstasy' has been linked to both systemic and neurological complications. A teenager presented with neck stiffness, headaches and nausea after ingesting 'Ecstasy'. A brain CT was negative for SAH but a CT angiogram suggested cerebral vasculitis. A lumbar puncture showed SAH but a cerebral angiogram was negative. After a spinal MR angiogram identified abnormalities on the dorsal surface of the cervical spinal cord, a spinal angiogram demonstrated a left PSA 2 mm fusiform aneurysm. The patient underwent surgery and the aneurysmal portion of the PSA was excised without postoperative neurological sequelae. 'Ecstasy' can lead to neurovascular inflammation, intracranial hemorrhage, SAH and potentially even de novo aneurysm formation and subsequent rupture. PSA aneurysms may be treated by endovascular proximal vessel occlusion or open surgical excision.
Comparable studies
Other case reports and case series on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use | 1987 | Case series | n = 5 |
| Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... | 1996 | Case series | n = 7 |
| 'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA | 1987 | Case series | n = 5 |
| A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... | 1998 | Case study | n = 2 |
| Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... | 1994 | Case series | n = 13 |