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.