title: Stroke associated with cocaine use.
abstract: We describe eight patients in whom cocaine use was related to stroke and review 39 cases from the literature. Among these 47 patients the mean (+/- SD) age was 32.5 +/- 12.1 years; 76% (34/45) were men. Stroke followed cocaine use by inhalation, intranasal, intravenous, and intramuscular routes. Intracranial aneurysms or arteriovenous malformations were present in 17 of 32 patients studied angiographically or at autopsy; cerebral vasculitis was present in two patients. Cerebral infarction occurred in 10 patients (22%), intracerebral hemorrhage in 22 (49%), and subarachnoid hemorrhage in 13 (29%). These data indicate that (1) the apparent incidence of stroke related to cocaine use is increasing; (2) cocaine-associated stroke occurs primarily in young adults; (3) stroke may follow any route of cocaine administration; (4) stroke after cocaine use is frequently associated with intracranial aneurysms and arteriovenous malformations; and (5) in cocaine-associated stroke, the frequency of intracranial hemorrhage exceeds that of cerebral infarction.
authors.affiliation: Department of Medicine, Peninsula Hospital, Burlingame, Calif.
authors.forename: D C
authors.initials: DC
authors.lastname: Klonoff
authors.forename: B T
authors.initials: BT
authors.lastname: Andrews
authors.forename: W G
authors.initials: WG
authors.lastname: Obana
mesh_terms: D000328:Adult; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000209:etiology*; D003042:Cocaine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications*; D014481:United States
chemical_list: D003042:Cocaine