CHANTER syndrome in a cocaine positive patient

CHANTER syndrome is a rare pattern of neurotoxicity characterized by restricted diffusion on magnetic resonance imaging in the cerebellum, hippocampi, and basal nuclei in a severe and symmetrical pattern. Multiple case studies have explored its likely etiology being recent opioid or poly-substance u...

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Main Authors: Maxwell Meadow, BA, Michelle Tsai, MD, Samuel Carter, DO
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325004467
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author Maxwell Meadow, BA
Michelle Tsai, MD
Samuel Carter, DO
author_facet Maxwell Meadow, BA
Michelle Tsai, MD
Samuel Carter, DO
author_sort Maxwell Meadow, BA
collection DOAJ
description CHANTER syndrome is a rare pattern of neurotoxicity characterized by restricted diffusion on magnetic resonance imaging in the cerebellum, hippocampi, and basal nuclei in a severe and symmetrical pattern. Multiple case studies have explored its likely etiology being recent opioid or poly-substance use. However, few case studies have found this syndrome after recent cocaine mono-use. In this report we describe an individual admitted to the Neurosciences Intensive Care Unit who had imaging findings most consistent with CHANTER syndrome and a urine toxicology screen positive only for cocaine. The patient was treated with high-dose thiamine, folate, amantadine, modafinil and was discharged to a long term acute care facility. Possible mechanisms of injury are explored such as damage from vasospasm, vasoconstriction, impairment of dopamine and glutamate neurotransmission, oxidative stress from cocaine metabolites, and direct mitochondrial damage. This case adds to a newly established growing body of literature on CHANTER syndrome to support future diagnosticians in reviewing patients with characteristic neuroimaging findings and a recent history of cocaine use.
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spelling doaj-art-1c5bc80c3b97495dbb3e606bc696ce5f2025-08-20T02:05:13ZengElsevierRadiology Case Reports1930-04332025-08-012084123412710.1016/j.radcr.2025.05.013CHANTER syndrome in a cocaine positive patientMaxwell Meadow, BA0Michelle Tsai, MD1Samuel Carter, DO2Ochsner Clinical School, The University of Queensland, 1514 Jefferson Hwy, Jefferson, LA 70121, USA; Corresponding author.Department of Neurology, Ochsner Medical Center, 1514 Jefferson Hwy, Jefferson, LA 70121, USADepartment of Neurocritical Care, Ochsner Medical Center, 1514 Jefferson Hwy, Jefferson, LA 70121, USACHANTER syndrome is a rare pattern of neurotoxicity characterized by restricted diffusion on magnetic resonance imaging in the cerebellum, hippocampi, and basal nuclei in a severe and symmetrical pattern. Multiple case studies have explored its likely etiology being recent opioid or poly-substance use. However, few case studies have found this syndrome after recent cocaine mono-use. In this report we describe an individual admitted to the Neurosciences Intensive Care Unit who had imaging findings most consistent with CHANTER syndrome and a urine toxicology screen positive only for cocaine. The patient was treated with high-dose thiamine, folate, amantadine, modafinil and was discharged to a long term acute care facility. Possible mechanisms of injury are explored such as damage from vasospasm, vasoconstriction, impairment of dopamine and glutamate neurotransmission, oxidative stress from cocaine metabolites, and direct mitochondrial damage. This case adds to a newly established growing body of literature on CHANTER syndrome to support future diagnosticians in reviewing patients with characteristic neuroimaging findings and a recent history of cocaine use.http://www.sciencedirect.com/science/article/pii/S1930043325004467CHANTER syndromeCocaineCase reportCerebellumHippocampusBasal nucleus
spellingShingle Maxwell Meadow, BA
Michelle Tsai, MD
Samuel Carter, DO
CHANTER syndrome in a cocaine positive patient
Radiology Case Reports
CHANTER syndrome
Cocaine
Case report
Cerebellum
Hippocampus
Basal nucleus
title CHANTER syndrome in a cocaine positive patient
title_full CHANTER syndrome in a cocaine positive patient
title_fullStr CHANTER syndrome in a cocaine positive patient
title_full_unstemmed CHANTER syndrome in a cocaine positive patient
title_short CHANTER syndrome in a cocaine positive patient
title_sort chanter syndrome in a cocaine positive patient
topic CHANTER syndrome
Cocaine
Case report
Cerebellum
Hippocampus
Basal nucleus
url http://www.sciencedirect.com/science/article/pii/S1930043325004467
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