Cerebral vasculitis associated with cocaine abuse.
BACKGROUND
Earlier reports of cocaine-associated cerebral vasculitis have been based primarily on angiographic findings without pathological verification.


METHODS
We present a case of acute encephalopathy following intravenous and intranasal administration of cocaine. Brain biopsy revealed vascular changes involving primarily small arteries. Findings included lymphocytic infiltration, endothelial thickening, and deposition of proteinaceous amorphous material within and around vessel walls.


CONCLUSIONS
These abnormalities are consistent with pathological features of arteritis previously reported in association with amphetamine and multiple-drug abuse. Vasospasm-induced changes are an alternative explanation for the vascular picture seen in this case. The patient made modest improvement with high-dose intravenous steroids.
Fredericks
R K
RK
Department of Neurology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103.
Lefkowitz
D S
DS
Challa
V R
VR
Troost
B T
BT
D000328:Adult; D001706:Biopsy; D001921:Brain / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000473:pathology; D003042:Cocaine; D005260:Female; D006801:Humans; D019966:Substance-Related Disorders / Q000150:complications*; D014657:Vasculitis / Q000209:etiology* / Q000473:pathology
D003042:Cocaine