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Cocaine induced hypertensive encephalopathy.

R P Grewal¹, B L Miller

¹Department of Neurology, Harbor-UCLA Medical Center, Torrance.

Acta Neurologica

|June 1, 1991

Summary

This case study highlights a patient with severe hypertension and hypertensive encephalopathy due to chronic cocaine abuse. Captopril, added to nitroprusside, effectively managed the condition when nitroprusside alone failed.

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Area of Science:

Cardiology
Neurology
Toxicology

Background:

Cocaine abuse is a known cause of severe hypertension and associated neurological complications.
Hypertensive encephalopathy is a critical condition requiring prompt and effective blood pressure management.

Observation:

A 40-year-old patient with a history of chronic cocaine abuse presented with extremely high blood pressure (260/160 mmHg).
Symptoms included severe headache, agitation, and bilateral papilledema, indicative of hypertensive encephalopathy.
Initial treatment with intravenous nitroprusside alone was insufficient to control the patient's blood pressure.

Findings:

The patient showed a positive response to the addition of captopril to the intravenous nitroprusside therapy.
This combination therapy led to effective blood pressure control in a case of cocaine-induced hypertensive encephalopathy.

Implications:

This case underscores the potential severity of hypertensive emergencies linked to stimulant drug abuse.
It suggests that combination therapy, including ACE inhibitors like captopril, may be crucial for managing refractory hypertensive encephalopathy in cocaine users.
Further research into optimal pharmacological strategies for managing stimulant-induced hypertensive crises is warranted.

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