1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0d031f4a-f43b-4b53-be8b-9548d781729b] => Array
        (
            [runtime-id] => 0d031f4a-f43b-4b53-be8b-9548d781729b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [c7861f18-db6f-4665-84c0-6a1a415e0688] => Array
                        (
                            [runtime-id] => c7861f18-db6f-4665-84c0-6a1a415e0688
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [d2fd48ae-7f02-4bf5-84da-321f1accb256] => Array
        (
            [runtime-id] => d2fd48ae-7f02-4bf5-84da-321f1accb256
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [f9707a6e-917b-42af-b24b-e77a2187a48f] => Array
                        (
                            [runtime-id] => f9707a6e-917b-42af-b24b-e77a2187a48f
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [6796fd2e-7235-432e-89d2-df9226732edb] => Array
        (
            [runtime-id] => 6796fd2e-7235-432e-89d2-df9226732edb
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [d1ab5332-b051-4f08-9d95-3d241d776d9e] => Array
                        (
                            [runtime-id] => d1ab5332-b051-4f08-9d95-3d241d776d9e
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0d031f4a-f43b-4b53-be8b-9548d781729b] => Array
        (
            [runtime-id] => 0d031f4a-f43b-4b53-be8b-9548d781729b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [c7861f18-db6f-4665-84c0-6a1a415e0688] => Array
                        (
                            [runtime-id] => c7861f18-db6f-4665-84c0-6a1a415e0688
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0d031f4a-f43b-4b53-be8b-9548d781729b] => Array
        (
            [runtime-id] => 0d031f4a-f43b-4b53-be8b-9548d781729b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [c7861f18-db6f-4665-84c0-6a1a415e0688] => Array
                        (
                            [runtime-id] => c7861f18-db6f-4665-84c0-6a1a415e0688
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0d031f4a-f43b-4b53-be8b-9548d781729b] => Array
        (
            [runtime-id] => 0d031f4a-f43b-4b53-be8b-9548d781729b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [c7861f18-db6f-4665-84c0-6a1a415e0688] => Array
                        (
                            [runtime-id] => c7861f18-db6f-4665-84c0-6a1a415e0688
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [0d031f4a-f43b-4b53-be8b-9548d781729b] => Array
        (
            [runtime-id] => 0d031f4a-f43b-4b53-be8b-9548d781729b
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [c7861f18-db6f-4665-84c0-6a1a415e0688] => Array
                        (
                            [runtime-id] => c7861f18-db6f-4665-84c0-6a1a415e0688
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)
1naresh2naresh
Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [03bdc56c-c2f3-4398-abeb-16edb5e4d553] => Array
        (
            [runtime-id] => 03bdc56c-c2f3-4398-abeb-16edb5e4d553
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => FreeToRead
            [privilege] => Array
                (
                    [1191b58e-8baf-40fb-ad96-6877ec558e23] => Array
                        (
                            [runtime-id] => 1191b58e-8baf-40fb-ad96-6877ec558e23
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;bb29a7defe3691bb2f3447d8da26447d3d53914a
                )

        )

)


  
    




























































    Neuroradiology and Drug Abuse: A Picture Is Worth a Thousand Words | American Journal of Neuroradiology  
    



















    































    
  
  




    
    

  

      


    

      

  
  
  

    

  

    

  

                
    

      

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



    

  


  


  


  
  
  
  
  
  

  	      


    
      

    
  
    
        
    

  

    
                        

  

                
    

      

	  

		
		

			

			  

  
      
  
  

    

  
  
      
EditorialEDITORIALS

  
      

  
      
Neuroradiology and Drug Abuse: A Picture Is Worth a Thousand Words
  
    	
Andrei I. Holodny

  
    	
American Journal of Neuroradiology August 2002,  23 (7) 1072-1073; 

  
  
  



  


  
  



			

		

	
	
 	
	  
  

		
		

			

			  

  
      
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    
Drug abuse continues to be the scourge of the modern world, affecting the destitute and underprivileged, as well as the most affluent in all countries. In the current issue of the AJNR, Aydin et al (page 1173) describe and catalogue the neuroradiologic findings of a form of drug abuse, chronic toluene inhalation, as depicted on MR images.
In this article, the authors document abnormalities in the white matter tracts and in the thalami of chronic toluene abusers and detail the concordance of the MR findings with the results of the neurologic examination. In the study population, in which the average patient age was 17.5 years, the neurologic signs and symptoms included insomnia and forgetfulness in 83%, tremors in 54%, ataxia and disturbed cerebellar test performance in 49%, rigidity in 24%, and dysarthria in 10%. The authors also found that the severity of the white matter disease is correlated with the duration of abuse. In addition, the following neuroradiologic findings were seen on the MR images: 1) hyperintensities in the cerebellum, brain stem, and upper cervical cord at T2-weighted imaging; 2) generalized atrophy of the brain; 3) thinning of the corpus callosum; and 4) abnormalities in the substantia nigra, the red nucleus, and the hippocampus. MR findings of severe abnormalities in what should be pristine adolescent brains are truly disturbing. It is also important to remember that this type of drug abuse is certainly prevalent in the United States and Europe. This sobering thought may spur some of us on to fulfill our social responsibilities.
I certainly hope that, when each of us writes or reads a scientific paper, we strive to accomplish more than just describe a disease process. Our work should offer concrete benefit for human beings. As neuroradiologists, what can we do to combat drug abuse? Clearly, images can serve as a powerful deterrent. For example, I remember being in grade school, when images from an anti-smoking campaign showed the difference between healthy lungs and smokers’ lungs.
However, perhaps the strongest testament to the power of a radiologic image is conveyed by the noted cardiologist and Nobel Prize winner Evgeni Chazov (1). He describes the situation in communist Mongolia in 1984 when the country was ruled by the aging Yumjaagiyn Tsedenbal, who according to Chazov, lost his mental faculties and left all decision making to his rude power-hungry wife. Removing the leader was not all that easy, and the members of the government were reluctant to move against Tsedenbal, although they understood his limited mental capacity. His ouster was facilitated by sending Tsedenbal for a health check-up that included CT of the brain. Needless to say, the images showed severe atrophy. Chazov showed the CT scan, along with a CT scan of normal brain for comparison, to the members of the Mongolian politburo. After seeing the severe atrophy of Comrade Tsedenbal’s brain, they quickly deposed him.
All neuroradiologists know that cerebral atrophy does not necessarily connote dementia. Also, I do not know whether the change in governmental leadership has improved the welfare of the Mongolian people. Nevertheless, the fact remains that a single neuroradiologic image is powerful enough to bring about a change in the leadership of a communist country.
I am far from advocating the platonic aphorism that we make mistakes only because of ignorance. Clearly, neuroradiology cannot conquer the problem of drug abuse. MR images cannot solve life’s challenges (eg, homelessness, stark poverty, orphanhood) that perhaps led the child and adolescent subjects of the current study to turn to drugs. Nevertheless, the episode described earlier demonstrates how powerful a single neuroradiologic image can be. We can only hope that work such as the current article that demonstrates the damage inflicted on young brains by drug abuse can be used to influence young minds. Perhaps showing a 14-year-old youth that his brain will look like that of an 85-year-old man may convince him not to start sniffing glue.
References
  1. ↵
    Chazov E. Health and Power. Moscow, Russia: Novosti;1992 :60–65
  


  
  



  
      
  
  

    
  


  
  



  




  


  
  



  
      
  
  

    
  


  
  



  
      
  
  

     Back to top  


  
  



			

		

		
		

			

			  

  
        
In this issue

    
  
  

    
  


  
  



  
      
  
  

    

  

    

  
      
  
  

    


Advertisement



  



  


  
  



  



  


  
  



  
      
  
  

    

	  
  

		

          

            

  
      
  
  

     Print  


  
  



  
      
  
  

     Download PDF  


  
  



  
      
  
  

    
 Email Article
  


  
  



  
      
  
  

    
 Citation Tools
  


  
  



          

        

        
        

          

            



  
      
  
  

    

  

    

  
      
  
  

    

  
  
  
  
      
Neuroradiology and Drug Abuse: A Picture Is Worth a Thousand Words
  
    	
Andrei I. Holodny

  
    	
American Journal of Neuroradiology Aug 2002, 23 (7) 1072-1073; 

  
  
  



  


  
  



  
      
  
  

    

  
    
  
  
    
  
  
    
  


  


  
  



  
      
  
  

    
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  


  
  



  



  


  
  



  
      
  
  

    
  


  
  



          

        

	
 	
	
	


  


  
  



  
        
Jump to section

    
  
  

    
  


  
  



  
      
  
  

    

  

    
 Related Articles
  • No related articles found.
 Cited By...
  • No citing articles found.
 More in this TOC Section
 Similar Articles

  



  


  
  



			

		

	
	
 	
	
	


    

  



  

                
    

      

  

    

  
      
  
  

    


Advertisement