Takeaway
- In young adults experiencing fatal stroke, psychostimulants are a common cause.
- In users, these strokes are often intraparenchymal and hemorrhagic, contributing to their lethality.
Why this matters
- Psychostimulant use is popular and on the rise.
- Increased stroke risk attends use of methamphetamine and cocaine, via any route.
- Young people experiencing a methamphetamine-related hemorrhagic stroke have higher death risk.
- Proportion of users experiencing stroke has not been previously reported, according to authors.
Key results
- Mean age, 36.9 years; males, 50.9%.
- 17.9% (50) were psychostimulant users, usually of methamphetamine (42).
- Cocaine, MDMA, dimethylamine, and phentermine each accounted for 1-2 cases.
- Hemorrhagic stroke was the most common type.
- In most psychostimulant users, this occurred intraparenchymally.
- In nonusers, subarachnoid was most common location.
- In both groups, ruptured berry aneurysm was frequent.
Study design
- Analysis of adults aged 15-44 years experiencing fatal stroke in Australian national coroner database, 2009-2016 (n=279).
- Outcomes: proportion using psychostimulants who experience fatal stroke; comparative characteristics vs other young adults experiencing fatal stroke.
- Funding: Australian government.
Limitations
- Only 197 cases had blood toxicology results available, potentially skewing rate estimates.
- Some stroke deaths may not have been referred to coroner.
- Use patterns may differ in other countries.
References
References
