Intracranial Vascular Complications of "Molly" Usage: Case Report and Review of the Literature.

"Molly" is a form of 3,4-methylene-dioxy-methamphetamine (MDMA, or "ecstasy"), a synthetic sympathomimetic drug, that acts as a stim- ulant and a hallucinogen. It is considered by users to be free of adulterants like methamphetamine, and therefore safer to use. It is either ingested as an oral capsule, snorted in powder form, or smoked as an additive to marijuana. Intracranial hemorrhages have been reported in patients who have taken MDMA, who have usually been found to have preexisting aneurysms, arteriovenous malformations, or vasculitis. There have been a few case reports of spontaneous intracranial hemorrhage in patients who have taken molly in endemic areas such as South Florida. We report one case of spontaneous subarachnoid hemorrhage and small acute cerebellar infarction in an otherwise healthy patient after ingestion of molly. As its usage increases, it is important to consider subarachnoid hemorrhages and cerebrovascular accidents as complications of molly abuse.