Objective To study the clinical manifestation and MRI feature on toxic encephalopathy after inhaling and injecting heroin. Methods 4 patients with toxic encephalopathy induced by inhaling, injecting heroin were observed with clinical and MRI. Results The 4 patients were male, they all had definite addiction histories (the time of addiction for 4 months to 7 years), there were special language and retropulsive dystonia besides there were common characteristics of toxic encephalopathy: reaction retardation, disturbance of intelligence, MRI showed the change of generalized demyelination in bilateral symmetrical cerebral hemisphere, posterior limbs of internal capsule, corpus callosum, medial lemniscus, cerebellum hemisphere dentate nucleus. The clinical symptom of 1 patient treated by adrenocortical steroid disappeared nearly 11 months after the onset of disease, 2 patients’ condition was remitted 3 months after treatment, 1 patient with 7 years inhaling history died the 55th day after the deterioration of disease. Conclusion Clinical manifestation and MRI on toxic encephalopathy after inhaling and injecting heroin were known, so we could diagnose the patients of the disease in time.

Objective To analyze the clinical features,risk factors,imaging features and prognoses of cerebral infarction menifested as isolated acute vestibular syndrome (AVS) to improve the diagnoses and treatments of the disease.Methods Clinical data of 15 cerebral infarction patients menifested as isolated AVS,admitted to our hospital from October 2015 to April 2016,were summarized retrospectively.The clinical features,risk factors,imaging features and prognoses of these patients were analyzed.Results (1) Clinical characteristics:the average age of cerebral infarction patients menifested as isolated AVS was 62.1 ±13.5 years old,and the median attack time was 24 (4-168) h;the main clinical manifestations were vertigo,including nausea (n=1 1),vomiting (n=10),nystagmus (n=10),and unstable gait (n=14).(2) Risk factors:14 patients had multiple risk factors of stroke (＞4),and they were age,hypertension,hypedipidemia,diabetes,smoking,carotid stenosis,history of stroke,white matter degeneration,coronary heart disease,and atrial fibrillation.(3) Imaging features:14 patients were posterior circulation infarction,and the lesions were located in the cerebellar hemisphere (n=l 1),cauda cerebelli (n=4),pons (n=3),brachium pontis (n=1),brachium inferius cerebelli (n=1);inferior colliculus (n=1),and multiple lesions occurred in 6 patients;one anterior circulation infarction was located in the insula;most lesions were smaller lacunar infarcts,but the lower part of cerebellar hemisphere was mostly larger infarct.(4) Prognoses:the prognosis of patients is good after regular treatment,9 had complete symptom relief,and 6 got improvement.Conclusions When patients presented with isolated AVS and many risk factors exist in clinic,the possibility of cerebral infarction should be taken into account.Such patients should be subjected to relevant examinations in a timely manner and early diagnosis,so that they can get regular treatment as soon as possible and prognoses can be improved.