RT Journal Article
SR Electronic
T1 Embolic stroke associated with injection of buprenorphine tablets
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 876
OP 879
DO 10.1212/WNL.0b013e3181b784c0
VO 73
IS 11
A1 Lim, C. C. Tchoyoson
A1 Lee, Sze Haur
A1 Wong, Yee-Choon
A1 Hui, Francis
YR 2009
UL http://n.neurology.org/content/73/11/876.abstract
AB Background: Drug users who crush, dissolve, and inject buprenorphine tablets parenterally may be at risk of severe thromboembolic complications or death. We describe patients with neurologic complications after injecting buprenorphine tablets. Methods: Brain MRI including diffusion-weighted imaging (DWI) in patients admitted to the neurologic department after injecting buprenorphine tablets were reviewed. Results: Seven men had neurologic complications after buprenorphine tablet injection. In 5 patients, multiple small scattered hyperintense lesions were detected on DWI in the cortex, white matter, and basal ganglia of the cerebral hemisphere; one patient had a single small lesion. The side of MRI abnormality corresponded to the side of needle marks on the neck except in one patient who had bilateral injections. One patient, who denied injecting into the neck, had DWI abnormalities in the middle cerebral artery territory on one side and occlusion of the ipsilateral internal carotid artery. Conclusions: Buprenorphine tablets can be intentionally or inadvertently injected into the carotid artery, causing a characteristic appearance on diffusion-weighted imaging, consistent with embolic cerebral infarction. DWI=diffusion-weighted imaging; ICA=internal carotid artery; MCA=middle cerebral artery; MRC=Medical Research Council.