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Intracranial Pressure-Guided Therapy in 3,4-Methylenedioxymethamphetamine (MDMA)-Induced Cerebral Edema: A Case Report

Haytham Khalifa, Mohamed Abdulmajeed

Cureus August 1, 2025 DOI: 10.7759/cureus.90328 via Semantic Scholar

Summary

A 21-year-old woman collapsed after taking MDMA (ecstasy) and drinking large volumes of water, developing severe cerebral edema and hyponatremia. She was intubated, transferred to a tertiary center, and managed with intracranial pressure (ICP) monitoring and careful sodium correction. She made a full recovery and was discharged from intensive care within four days. This case illustrates that ICP-guided management can help optimize care and reduce risks in patients with MDMA-related cerebral edema.

Study at a glance

Characteristics Case study Case report Peer reviewed
Sample size 1
Population 21-year-old woman with MDMA toxicity and hyponatremia
Keywords Medicine
Citations 2
Key finding ICP-guided management of cerebral edema and hyponatremia led to full recovery in a patient with severe MDMA toxicity.

Abstract

3,4-Methylenedioxymethamphetamine (MDMA), commonly called ecstasy, is a synthetic stimulant popular among young adults. Although its psychoactive effects are sought after, MDMA can lead to serious complications, including neurological and cardiovascular crises. Severe toxicity, although uncommon, may result in cerebral edema, hyponatremia, seizures, or death. We describe the case of a 21-year-old woman who collapsed after taking MDMA and drinking large volumes of water. On arrival at the hospital, she was found to have significant cerebral edema and low sodium. After endotracheal intubation and transfer to a tertiary center, she was managed with intracranial pressure (ICP) monitoring and careful correction of hyponatremia. She made a full recovery and was discharged from intensive care within four days. This report highlights how ICP-guided management can help optimize care and reduce risks in patients with MDMA-related cerebral edema.

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