Acute cocaine abuse associated with cerebral infarction

We present the case of a 29-year-old patient who developed a cerebral infarction, without hemorrhage, after using cocaine. A computed tomography scan of the brain at the time of initial presentation was entirely normal; a repeat CT scan on the fifth hospital day showed a basal ganglion infarction. No evidence of intracranial bleeding was detected. Theories of cocaine-induced cerebral infarction, including promotion of thrombogenesis and vasospasm, are reviewed.