Cocaine dependence and stroke: pathogenesis and management.
Cocaine abuse remains a devastating medical problem for our society. Current concepts suggest that both hemorrhagic and ischemic stroke, particularly in young people, can result as a consequence of cocaine exposure. We provide an analysis of mechanisms of injury and a discussion of the pharmacological management of stroke following cocaine use. Preclinical research suggests that the cause of cocaine-mediated stroke is multifactorial and involves vasospasm, changes in cerebral vasculature, and platelet aggregation. We suggest that drugs able to induce vasospastic, thrombogenic, or neurotoxic effects of cocaine could be suitable as therapeutic agents. In contrast caution should be exerted when using anti-platelet and thrombolytic agents in cocaine users with stroke.
Clinical Specialist (Neurologist), Department of Neurology, Annunziata Hospital, Via F. Migliori, 1 - 87100 Cosenza, Italy. anto.siniscalchi@libero.it.
Antonio
A
Siniscalchi
Antonello
A
Bonci
Nicola Biagio
NB
Mercuri
Antonia
A
De Siena
Giovambattista
G
De Sarro
Giovanni
G
Malferrari
Marco
M
Diana
Luca
L
Gallelli
D000818:Animals; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications*; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects*; D006801:Humans; D020521:Stroke / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy
D018765:Dopamine Uptake Inhibitors; D003042:Cocaine