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.