Abstract：
UNASSIGNED: Watershed infarcts (WIs) are a distinct type of stroke with a varying clinical presentation that affects the border areas between the territories of two cerebral arteries and are typically associated with hemodynamic impairment and internal carotid artery stenosis. However, there is a paucity of data concerning its association with the history of recreational substance and drug abuse.
UNASSIGNED: This case report presents a unique instance of bilateral internal watershed infarcts in a 23-year-old male with a history of polysubstance abuse, including methadone and cocaine. The patient\'s presentation included confusion, lower limb weakness, and systemic complications such as acute liver injury and myonecrosis, underlying the complexity of the clinical scenario.
UNASSIGNED: The investigation revealed no evidence of arterial stenosis or thrombosis, leading to the conclusion that the infarctions were likely precipitated by a total loss of consciousness due to substance abuse-related cerebral hypoperfusion and vasoconstriction. Methadone and cocaine, both implicated in vasoconstriction, lowering the seizure threshold and contributing to QTc prolongation, thus leading to loss of consciousness, were identified as potential triggers for the episode.
UNASSIGNED: In the young adult population, it is important to consider drug abuse as an etiological trigger for watershed infarcts, whereas the multi-system involvement and atypical presentation highlight the need for a comprehensive approach.
UNASSIGNED: This case report presents a unique instance of bilateral internal watershed infarcts in a 23-year-old male with a history of polysubstance abuse, including methadone and cocaine. The patient\'s presentation included confusion, lower limb weakness, and systemic complications such as acute liver injury and myonecrosis, underlying the complexity of the clinical scenario.
UNASSIGNED: The investigation revealed no evidence of arterial stenosis or thrombosis, leading to the conclusion that the infarctions were likely precipitated by a total loss of consciousness due to substance abuse-related cerebral hypoperfusion and vasoconstriction. Methadone and cocaine, both implicated in vasoconstriction, lowering the seizure threshold and contributing to QTc prolongation, thus leading to loss of consciousness, were identified as potential triggers for the episode.
UNASSIGNED: In the young adult population, it is important to consider drug abuse as an etiological trigger for watershed infarcts, whereas the multi-system involvement and atypical presentation highlight the need for a comprehensive approach.
摘要：
■分水岭梗死(WIs)是一种不同类型的卒中,其临床表现变化,影响两个脑动脉区域之间的边界区域,并且通常与血流动力学损害和颈内动脉狭窄相关。然而,关于其与娱乐性物质和药物滥用历史的关联的数据很少。
本病例报告显示了一名23岁男性的双侧内部分水岭梗塞的独特实例，该患者有多种物质滥用史，包括美沙酮和可卡因.病人的陈述包括混乱，下肢无力,和全身性并发症，如急性肝损伤和心肌坏死，潜在的临床方案的复杂性。
■调查显示没有动脉狭窄或血栓形成的证据，得出的结论是，梗死可能是由于药物滥用相关的脑灌注不足和血管收缩导致的完全意识丧失。美沙酮和可卡因,两者都与血管收缩有关,降低癫痫发作阈值并导致QTc延长，从而导致意识丧失,被确定为该事件的潜在触发因素。
■在年轻的成年人口中，重要的是将药物滥用视为分水岭梗塞的病因诱因，而多系统的参与和非典型的表现突出了全面方法的必要性。
本病例报告显示了一名23岁男性的双侧内部分水岭梗塞的独特实例，该患者有多种物质滥用史，包括美沙酮和可卡因.病人的陈述包括混乱，下肢无力,和全身性并发症，如急性肝损伤和心肌坏死，潜在的临床方案的复杂性。
■调查显示没有动脉狭窄或血栓形成的证据，得出的结论是，梗死可能是由于药物滥用相关的脑灌注不足和血管收缩导致的完全意识丧失。美沙酮和可卡因,两者都与血管收缩有关,降低癫痫发作阈值并导致QTc延长，从而导致意识丧失,被确定为该事件的潜在触发因素。
■在年轻的成年人口中，重要的是将药物滥用视为分水岭梗塞的病因诱因，而多系统的参与和非典型的表现突出了全面方法的必要性。
