MR imaging of 'spray heads': Toluene abuse via aerosol paint inhalation

PURPOSE: Three male patients with a history of spray-paint inhalation are presented. METHODS: Spin-echo MR was used to evaluate the central nervous system changes secondary to toluene inhalation delivered via spray-paint fumes. RESULTS: The remarkable findings included the loss of cerebral and cerebellar gray-white matter discrimination, scattered multifocal deep white matter lesions, and gross generalized atrophy of the cerebrum, the cerebellum, and the corpus callosum. CONCLUSION: Although the observed changes are nonspecific, combined with a positive history the diagnosis of inhalation toluene abuse can be made on the basis of consistent MR findings.