Document Detail


Neurovascular complications of cocaine.
MedLine Citation:
PMID:  7801738     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Use of cocaine in the USA, has reached epidemic proportions since 1983, when "crack" was introduced, its higher potency compared with cocaine HCl has been associated with a tremendous increase in the incidence of strokes. This study reports our experience with 55 cases of neurovascular events (25 ischemic and 30 hemorrhagic) related to cocaine use in 54 patients. Only 15 patients had other risk factors for stroke. Twenty six patients smoked "crack", 10 snorted cocaine and 12 injected it intravenously. Strokes occurred within 3 h of cocaine use in 15 patients with infarcts and 17 with hemorrhages. Ten infarcts occurred after an overnight binge. Of the hemorrhage group 9 were subarachnoid, 16 intracerebral (8 basal ganglia, 7 hemispheric and one brain stem) and 5 intraventricular. Computerized tomography (CT) showed an aneurysm of the anterior communicating artery, as well as one of the vein of Galen. Four aneurysms and 3 AVMs were identified on angiography. CT revealed 15 infarcts; it was normal in 7 patients with pure motor hemiparesis and in 3 with findings consistent with anterior spinal artery infarction. Several mechanisms may be responsible for the cerebrovascular complications. A sudden rise in systemic arterial pressure may cause hemorrhages, frequently in association with an underlying aneurysm or AVM. Vasospasm, arteritis, myocardial infarction with cardiac arrhythmias and increased platelet aggregation may provoke infarcts.
Authors:
M Daras; A J Tuchman; B S Koppel; L M Samkoff; I Weitzner; J Marc
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  90     ISSN:  0001-6314     ISO Abbreviation:  Acta Neurol. Scand.     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1995-01-25     Completed Date:  1995-01-25     Revised Date:  2006-08-16    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  124-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, New York Medical College, NY 10029.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Ischemia / chemically induced*,  radiography
Cerebral Hemorrhage / chemically induced*,  radiography
Cocaine / adverse effects*
Crack Cocaine / adverse effects*
Female
Humans
Male
Middle Aged
Neurologic Examination / drug effects
Risk Factors
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Crack Cocaine; 50-36-2/Cocaine

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


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