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Encephalopathy and biopsy-proven cerebrovascular inflammatory changes in a cocaine abuser.
MedLine Citation:
PMID:  10210820     Owner:  NLM     Status:  Publisher    
Cocaine abuse is a well known cause of cerebrovascular complications. An inflammatory vasculopathy hypothesis has been proposed, but the medical literature has only reported a few pathological confirmations. We report a case with a biopsy demonstrating cerebral inflammatory vascular changes that are associated with cocaine abuse. A 21-year-old male, a twice weekly cocaine abuser, developed encephalopathy, apraxia and left hemiparesis with hemisensory loss during the first week after his last cocaine intake; postural tremor and dystonia appeared later. Laboratory data were unrevealing. Cerebral angiography showed a lack of vascularization in the left precentral and central arterial groups. A corticomeningeal cerebral biopsy demonstrated perivascular cell collection and transmural lymphomonocytic infiltration of the small cortical vessels. All symptoms improved with corticosteroid treatment, but 4 years later, the patient returned with a worsening of his encephalopathy and a severe memory impairment, emotional lability and apraxia. A cerebral magnetic resonance image (MRI) showed subcortical and periventricular lesions suggesting ischemic damage in small-size vessel areas as well as cortical atrophy. This new case supports the existence of an encephalopathy associated with vascular inflammatory changes in a cocaine abuser, although more clinical and experimental data are necessary to define its physiopathology.
Diez-Tejedor; Frank; Gutierrez; Barreiro
Publication Detail:
Journal Detail:
Title:  European journal of neurology : the official journal of the European Federation of Neurological Societies     Volume:  5     ISSN:  1468-1331     ISO Abbreviation:  Eur. J. Neurol.     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1999-04-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9506311     Medline TA:  Eur J Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  103-107     Citation Subset:  -    
Department of Neurology (Stroke Unit), Hospital Universitario La Paz, Universidad Autonoma de Madrid, Paseo de la Castellana, 261, Madrid, Spain.
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