[Cerebral infarction after cocaine use]

Abstract

Three relatively young patients, men aged 29 and 38 years and a woman aged 40 years, developed ischaemic stroke shortly after cocaine use. All three had used cigarettes or alcohol as well, and suffered from neurologic deficits with CT and MRI lesions. They recovered, but neurologic sequelae remained. Cocaine may induce haemorrhagic as well as ischaemic stroke. Different vascular complications of cocaine may be involved. The pathophysiologic mechanisms of cocaine-induced ischaemic stroke include vasoconstriction due to cerebrovascular spasms and serotoninergic action, and enhanced thrombocyte aggregation. Over the last years, the use of cocaine is rising, so that the number of cocaine-related stroke patients can be expected to increase. Cocaine use as a cause of ischaemic stroke is important to recognise because discontinuation of cocaine can prevent a recurrent stroke.