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Embolic stroke after smoking "crack" cocaine
G W Petty1, J C Brust, T K Tatemichi
1Department of Neurology, Harlem Hospital Center, New York.
Stroke
|November 1, 1990
Summary
Cocaine use can cause ischemic stroke through embolism. Cardiomyopathy, potentially from cocaine, may lead to cardiac thrombus and subsequent cerebral infarction.
Area of Science:
- Neurology
- Cardiology
- Toxicology
Background:
- Cocaine abuse is associated with various cardiovascular and cerebrovascular complications.
- Ischemic stroke is a known risk of stimulant drug use, but the specific mechanisms are not fully elucidated.
Observation:
- A 39-year-old woman presented with an embolic occlusion of a middle cerebral artery branch.
- This event occurred three hours after smoking crack cocaine.
- Cardiac evaluation revealed cardiomyopathy and a left atrial thrombus.
Findings:
- The case illustrates that embolism is a significant mechanism for cocaine-associated ischemic stroke.
- Cocaine-induced cardiomyopathy may serve as the source of the embolus.
- A left atrial thrombus was identified as the likely embolic source.
Implications:
- In patients with cocaine-associated cerebral infarction, a thorough cardiac evaluation is crucial.
- Identifying a cardiac source of embolism can guide treatment and prevention strategies.
- This highlights the complex interplay between recreational drug use and cardiovascular health impacting neurological outcomes.