Case Report
Impact of Methamphetamine Abuse: A Rare Case of Rapid
Cerebral Aneurysm Growth with Review of Literature
James Fowler,
1
Brian Fiani ,
1
Syed A. Quadri ,
1,2
Vladimir Cortez,
1
Mudassir Frooqui,
2
Atif Zafar ,
2
Fahad Shabbir Ahmed,
3
Asad Ikram,
2
Anirudh Ramachandran,
4
and Javed Siddiqi
1
1
Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, CA, USA
2
Department of Neurology, University of New Mexico, Albuquerque, NM, USA
3
Department of Pathology, Yale School of Medicine, New Haven, CT, USA
4
College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
Correspondence should be addressed to Brian Fiani; bfani@outlook.com
Received 10 June 2018; Accepted 23 September 2018; Published 4 October 2018
Academic Editor: Isabella Laura Simone
Copyright © 2018 James Fowler et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Methamphetamine or “meth” is a sympathomimetic amine of the amphetamine-type substances (ATS) class with an extremely
high potential for abuse. Illicitly abused neurostimulants like cocaine and meth predispose patients to the aneurysmal formation
with reported rupture at a younger age and in much smaller sized aneurysms. However, very rapid growth of aneurysm within less
than 2 weeks with methamphetamine abuse is very rarely observed or reported. In this report, we present a patient with repeated
and recurrent meth abuse who demonstrated rapid growth of a pericallosal aneurysm over the period of less than two weeks. Te
pathophysiology of stroke related to meth and ATS abuse is multifactorial with hypertension, tachycardia, and vascular disease
postulated as major mechanisms. Te rapid growth of an aneurysm has a high risk of aneurysmal rupture and SAH, which is
a neurosurgical emergency and therefore warrants careful consideration and close monitoring. Tis case confrms the dynamic
temporal efects of methamphetamine use on intracranial vessels and this specifc neurostimulants association to rapid aneurysmal
formation. In light of vascular pathologies the possibility of drug-induced pseudoaneurysm should also be considered in young
patients with history of meth abuse.
1. Introduction
Methamphetamine, commonly known as “meth”, is a sym-
pathomimetic amine of the amphetamine-type substances
(ATS) class with an extremely high potential for abuse [1].
Tis abuse potential comes from side efects like euphoria,
hallucination, central nervous system (CNS) stimulation,
and anorexia. Excess use of meth has been implicated in
the formation of renal and splanchnic artery aneurysms
[2] and may cause myocardial infarction or stroke [3, 4].
Neurostimulants like cocaine and meth predispose patients to
the aneurysmal formation with reported rupture at an earlier
age and in much smaller sized aneurysms [4–7]
In this report, we present a patient with repeated and
recurrent meth abuse who demonstrated rapid growth of
a pericallosal aneurysm over the period of fewer than
two weeks. Such rapid growth of aneurysm in the major
intracranial vessels resulting from methamphetamine abuse
is very rare. Te pathophysiology of stroke form ATS Class
substances is multifactorial but preexisting vascular disease,
and meth-induced hypertension pays a major role [8]. Te
rapid growth of an aneurysm has a high risk of aneurysmal
rupture and SAH, which is a neurosurgical emergency [3, 9].
Some underlying risk factors have been identifed which can
be helpful in recognizing susceptible individuals, which can
beneft in clinical decision-making [10, 11].
2. Case
A 41-year-old Hispanic woman initially presented to the
emergency room (ER) in 2012 with a severe excruciating
headache for approximately 1 hour afer the use of meth.
Hindawi
Case Reports in Neurological Medicine
Volume 2018, Article ID 1879329, 5 pages
https://doi.org/10.1155/2018/1879329