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Cerebral vasculitis associated with cocaine abuse
R K Fredericks1, D S Lefkowitz, V R Challa
1Department of Neurology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103.
Stroke
|November 1, 1991
Summary
Cocaine use can cause cerebral vasculitis, confirmed by brain biopsy showing inflammation and damage to small arteries. Treatment with steroids showed modest improvement in this case of acute encephalopathy.
Area of Science:
- Neurology
- Pathology
- Toxicology
Background:
- Cocaine-associated cerebral vasculitis reports lacked pathological verification.
- Previous studies relied on angiographic findings only.
Observation:
- A case of acute encephalopathy after cocaine use is presented.
- The patient experienced symptoms following intravenous and intranasal cocaine administration.
Findings:
- Brain biopsy revealed vasculitis affecting small arteries.
- Pathological findings included lymphocytic infiltration, endothelial thickening, and proteinaceous material deposition.
- These changes resemble arteritis seen in amphetamine and multiple-drug abuse.
Implications:
- Pathological confirmation of cocaine-induced cerebral vasculitis.
- Vasospasm is a potential alternative explanation for vascular changes.
- High-dose steroids may offer modest improvement for affected patients.