Increasing evidence supports the relationship between cocaine and hemorrhagic stroke
in young patients, and the type of formulation plays an important role. High blood
pressure has been reported to be a common important risk factor for intracerabral
hemorrhage. We report the case of a 40-year-old woman who did not declare at admission
her 4-year history of intranasal cocaine hydrochloride and developed an intracerebral
subcortical spontaneous hemorrhage. She documented a normal blood pressure, and computer
tomography angiography did not show vascular abnormalities and excluded the presence
of arterial aneurisms. We performed a urine toxicology screen test revealing that
she was positive for cocaine. Various mechanisms are involved in the etiologies of
intracerebral hemorrhage in cocaine users. In the presence of normal blood pressure
without vascular abnormalities, an endothelial dysfunction cannot be excluded.
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References
- Editorial: Cocaine and Cerebral Small Vessel: Is it Negative Factor for Intravenous Thrombolysis?.Curr Vasc Pharmacol. 2016; 14: 304-306
- Cocaine Use and Risk of Ischemic Stroke in Young Adults.Stroke. 2016; 47: 918-922
- Cocaine dependence and stroke: pathogenesis and management.Curr Neurovasc Res. 2015; 12: 163-172
- Cocaine use as a predictor of outcome in aneurysmal subarachnoid hemorrhage.J Neurosurg. 2003; 99: 271-275
- A comparative study of the cerebrovascular complications of cocaine: alkaloidal versus hydrochloride-a review.Neurology. 1991; 41: 1173-1177
- Comparison of Blood Pressure–Associated Risk of Intracerebral Hemorrhage and Subarachnoid Hemorrhage Korea Medical Insurance Corporation Study.Hypertension. 2005; 46: 393-397
- Intracerebral haemorrhage.Lancet. 2009; 373: 1632-1644
- Characteristics and outcomes of cocaine-related spontaneous intracerebral hemorrhages.ISRN Neurol. 2013; 2013: 124390
- Intravenous tissue plasminogen activator in patients with cocaine-associated acute ischemic stroke.Stroke. 2009; 40: 3635-3637
- The Role of Topiramate in the Management of Cocaine Addiction: a Possible Therapeutic Option.Curr Neuropharmacol. 2015; 13: 815-818
Article Info
Publication History
Published online: September 03, 2016
Accepted:
September 1,
2016
Received in revised form:
August 31,
2016
Received:
August 24,
2016
Footnotes
?Conflicts of interest and source of funding: We did not receive funding for this research and we have not conflict of interest.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
