Psychostimulant Use and Fatal Stroke in Young Adults

J Forensic Sci. 2019 Sep;64(5):1421-1426. doi: 10.1111/1556-4029.14056. Epub 2019 Apr 2.

Abstract

Psychostimulant use is associated with increased stroke risk. To determine the proportion of psychostimulant users among fatal strokes in young adults (15-44 years), all cases were retrieved from the National Coronial Information System (1/1/2009-31/12/2016). A total of 279 cases were identified: hemorrhagic (259), ischemic (8), thrombotic (8), and mycotic (4). Fifty (17.9%) were identified as psychostimulant users. Psychostimulants in blood were detected in 37/45 where toxicology was available, predominantly methamphetamine (32/45). Hemorrhagic strokes in the psychostimulant group were more likely to be intraparenchymal (OR 2.33). Psychostimulant users were less likely to be obese (OR 0.31), but more likely to have a history of tobacco use (OR 2.64). No psychostimulant user had a previous stroke history, was gravid/postpartum, or diagnosed with cerebral vasculitis or endocarditis. The work illustrates the substantial role of psychostimulant use in fatal strokes among young adults. In cases of hemorrhagic stroke among young adults, psychostimulant use should be considered.

Keywords: fatal; forensic science; hemorrhagic; intraparenchymal; ischemic; psychostimulants; stroke.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Blood Alcohol Content
  • Brain Ischemia / mortality
  • Brain Ischemia / pathology
  • Central Nervous System Stimulants / adverse effects*
  • Central Nervous System Stimulants / blood
  • Coroners and Medical Examiners
  • Female
  • Humans
  • Intracranial Hemorrhages / mortality
  • Intracranial Hemorrhages / pathology
  • Male
  • Retrospective Studies
  • Stroke / mortality*
  • Substance-Related Disorders / epidemiology*
  • Tobacco Use Disorder / epidemiology
  • Young Adult

Substances

  • Blood Alcohol Content
  • Central Nervous System Stimulants