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

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.