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Neuroimaging Features of Heroin Inhalation Toxicity: "Chasing the Dragon"

¹ Department of Radiology, Vancouver Hospital and Health Sciences Centre UBC Site, 2211 Wesbrook Mall, Vancouver, B. C., V6T 2B5 Canada.
² Department of Neurology, Vancouver Hospital and Health Sciences Centre-UBC Site, Vancouver, B. C., V6T 2B5 Canada.

OBJECTIVE. Our objective was to illustrate the dramatic neuroimaging findings of toxic leukoencephalopathy caused by heroin vapor inhalation.

CONCLUSION. Symmetric abnormality involving the cerebellar white matter and posterior limb of the internal capsule is characteristic of heroin vapor inhalation toxicity, although involvement may be more extensive, depending on the severity of the condition. MR imaging and CT appear to be essential for making this diagnosis because clinical history is often unreliable and findings at physical examination are nonspecific.

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