Document Detail


Cocaine-induced encephalocele: case report and literature review.
MedLine Citation:
PMID:  21150742     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND IMPORTANCE: The abuse of cocaine can lead to significant destruction of midline craniofacial structures. This process occurs secondary to myriad mechanisms, including ischemic necrosis, irritation by chemical adulterants, and direct trauma during its administration. Coupled with a prolonged chronic infection of intranasal and anterior skull base regions, an encephalocele can be formed. We report a case of an encephalocele secondary to cocaine use and its associated complications.
CLINICAL PRESENTATION: A 56-year-old man presented with altered mental status and cerebritis secondary to the presence of an intranasal encephalocele. On computed tomography, extensive destruction of the anterior cranial fossa was observed. The patient had a 30-year history of intranasal cocaine abuse, and his urine tested positive for the presence of cocaine on admission. The patient was treated with intravenous antibiotics and underwent a repair of his cranial defect and resection of the encephalocele. The patient made a good recovery after treatment.
CONCLUSION: Alternative causes of an encephalocele, including trauma, surgery, and congenital malformation, were ruled out in this patient. Histopathological analysis of the necrotic tissue and the absence of renal or pulmonary disease also indicated that the patient did not suffer from Wegener granulomatosis, a known cause of spontaneous intranasal lesions. To the best of our knowledge, this is the first report of an encephalocele likely induced solely by cocaine abuse.
Authors:
Ladislau Albert; Joseph A DeMattia
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Neurosurgery     Volume:  68     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-14     Completed Date:  2011-04-13     Revised Date:  2012-05-25    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E263-6     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, New York Medical College, Valhalla, New York 10595, USA. lanrsg@optonline.net
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MeSH Terms
Descriptor/Qualifier:
Cocaine / adverse effects
Cocaine-Related Disorders / complications*
Dopamine Uptake Inhibitors / adverse effects
Encephalocele / etiology*,  surgery*
Humans
Male
Middle Aged
Nasal Septum / pathology,  surgery*
Reconstructive Surgical Procedures*
Chemical
Reg. No./Substance:
0/Dopamine Uptake Inhibitors; 50-36-2/Cocaine
Comments/Corrections
Comment In:
Neurosurgery. 2012 May;70(5):E1339   [PMID:  22307072 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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