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Labs: Hyperglycemia, hypokalemia, increased CPK, and increased CPK-MB. Electrocardiogram (ECG): All tachydysrhyth-mias increased, ischemia, MI. Head CT: All CVAs increased = subarach-noid hemorrhage (SAH), intracranial (ICH), interventricular hemorrhage (IVH), ischemic cerebral infarcts, septic cerebral emboli, brain abscesses.

Abdominal x-rays: Body packing mules vs. body stuffers; free air from perforated, necrotic bowel.

Figure 9.5 Intracranial Aneurysm: Crack Cocaine Inhalation. Cranial computerized axial tomogram (CT) at the level of the pons and the superior fourth ventricle in a crack cocaine abuser that demonstrates a right parasellar hyperdense rounded area consistent with a saccular aneurysm of the right posterior communicating artery. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.5 Intracranial Aneurysm: Crack Cocaine Inhalation. Cranial computerized axial tomogram (CT) at the level of the pons and the superior fourth ventricle in a crack cocaine abuser that demonstrates a right parasellar hyperdense rounded area consistent with a saccular aneurysm of the right posterior communicating artery. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.6 Intracranial Aneurysm: Crack Cocaine Abuser. Digital subtraction arteriogram in a lateral projection following radiographic contrast injection into the left internal carotid artery of a crack cocaine abuser that demonstrates a saccular aneurysm of the left posterior communicating artery. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.7 Intracranial and Interventricular Hemorrhage: Crack Cocaine Inhalation. Noncontrast computerized axial tomogram (CT) of the brain at the level of the third ventricle in a crack cocaine abuser that demonstrates a hyperdense lesion in the left basal ganglia, asymmetry of the left frontal ventricular horn, and interventricular hemorrhage in the right ventricular horn consistent with hypertensive intracranial hemorrhage with disruption into the ventricular system. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.8 Septic Cerebral Emboli with Brain Abscess. Axial Tl-weighted magnetic resonance image (MRI) of the brain at the level of the centrum semiovale that demonstrates a large cystic lesion with surrounding halos of vasogenic edema consistent with multiple septic emboli and resulting cerebral abscess in an intravenous crack cocaine abuser. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.9a Pneumomediastinum Following Crack Cocaine Inhalation. Frontal (9.9a) and lateral (9.9b) chest radiographs that demonstrate radiolucencies throughout the left lung interstitium, mediastinum, and base of the neck consistent with pulmonary interstitial emphysema, pneumomediastinum, and subcutaneous soft tissue emphysema following crack cocaine inhalation. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.9a Pneumomediastinum Following Crack Cocaine Inhalation. Frontal (9.9a) and lateral (9.9b) chest radiographs that demonstrate radiolucencies throughout the left lung interstitium, mediastinum, and base of the neck consistent with pulmonary interstitial emphysema, pneumomediastinum, and subcutaneous soft tissue emphysema following crack cocaine inhalation. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.7 Intracranial and Interventricular Hemorrhage: Crack Cocaine Inhalation. Noncontrast computerized axial tomogram (CT) of the brain at the level of the third ventricle in a crack cocaine abuser that demonstrates a hyperdense lesion in the left basal ganglia, asymmetry of the left frontal ventricular horn, and interventricular hemorrhage in the right ventricular horn consistent with hypertensive intracranial hemorrhage with disruption into the ventricular system. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.9b Pneumomediastinum Following Crack Cocaine Inhalation. Frontal (9.9a) and lateral (9.9b) chest radiographs that demonstrate radiolucencies throughout the left lung interstitium, mediastinum, and base of the neck consistent with pulmonary interstitial emphysema, pneumomediastinum, and subcutaneous soft tissue emphysema following crack cocaine inhalation. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.9b Pneumomediastinum Following Crack Cocaine Inhalation. Frontal (9.9a) and lateral (9.9b) chest radiographs that demonstrate radiolucencies throughout the left lung interstitium, mediastinum, and base of the neck consistent with pulmonary interstitial emphysema, pneumomediastinum, and subcutaneous soft tissue emphysema following crack cocaine inhalation. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.11 Fatal Mesenteric Infarction with Small Bowel Perforation. Noncontrast, computerized axial tomogram (CT) of the abdomen at the level of the uncinate process of the pancreas that demonstrates bowel gas in the main portal vein and its intrahepatic branches, extraperitoneal emphysema in the pro-peritoneal fat space and posterior pararenal space, pneumoperitoneum, and subcutaneous soft tissue emphysema following acute mesenteric infarction and subsequent small bowel perforation in an intravenous cocaine abuser. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.11 Fatal Mesenteric Infarction with Small Bowel Perforation. Noncontrast, computerized axial tomogram (CT) of the abdomen at the level of the uncinate process of the pancreas that demonstrates bowel gas in the main portal vein and its intrahepatic branches, extraperitoneal emphysema in the pro-peritoneal fat space and posterior pararenal space, pneumoperitoneum, and subcutaneous soft tissue emphysema following acute mesenteric infarction and subsequent small bowel perforation in an intravenous cocaine abuser. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

Figure 9.10 Dissecting Thoracic Aneurysm. Contrast-enhanced, T1-weighted, sagittal-oblique, computerized axial tomogram (CT) of the chest that demonstrates an intimal flap dividing the descending thoracic aorta into true and false lumens consistent with dissecting thoracic aneurysm Type B in an intravenous cocaine abuser. (Courtesy of Carlos R. Gimenez, M.D., Professor of Radiology, LSU School of Medicine, New Orleans, LA.)

MRI: Dissecting aortic aneurysm, pneumatosis intestinalis, portal and mesenteric venous air emboli.

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