Related Experiment Video
Updated: Apr 23, 2026
07:30
Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study
Published on: August 18, 2020
8.4K
Socioeconomic status does not predict cocaine use among ischemic stroke patients: A nested case-control study
Corey R Fehnel1, Alison M Ayres2, Natalia S Rost2
1Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, USA ; Department of Neurology, Massachusetts General Hospital, USA.
JRSM Cardiovascular Disease
|September 24, 2014
Summary
Cocaine use in stroke patients is not linked to socioeconomic status. Active tobacco use and a history of migraine independently increased cocaine use odds in stroke patients.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Previous research on cocaine use and stroke primarily focused on acute effects in high-risk groups.
- Limited understanding exists regarding the broader risk factors and mechanisms of cocaine use among diverse ischemic stroke populations.
Purpose of the Study:
- To characterize mechanisms and risk factors for cocaine use in ischemic stroke patients across varied socioeconomic backgrounds.
- To inform medical management and prevention strategies for cocaine-associated strokes.
Main Methods:
- A study of consecutive adult ischemic stroke patients admitted between January 2007 and December 2010 with confirmed cocaine use (cases).
- Comparison of demographics, risk factors, and clinical/imaging data with age, sex, and race-matched cocaine-negative controls.
- Statistical analysis to identify predictors of cocaine use, including socioeconomic factors, tobacco use, migraine history, and stroke subtype.
Main Results:
- Out of 4073 stroke patients, 91 (2.2%) reported cocaine use or had a positive toxicology screen.
- Cocaine users did not differ from controls in occupation, income, or education.
- Active tobacco use (OR 3.9) and migraine history (OR 2.5) were independent predictors of cocaine use; stroke subtype also predicted use (OR 0.73).
Conclusions:
- Socioeconomic factors do not distinguish stroke patients with cocaine use from non-users.
- Wider use of toxicology screening is recommended for identifying cocaine use in broader patient populations.
- Further research into the causal mechanisms of cardioembolism in cocaine-associated stroke is necessary.
Related Concept Videos
01:15Ischemic Stroke l: Introduction
21
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
21
01:15Ischemic Stroke ll: Pathophysiology
21
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
21
01:29Hemorrhagic Stroke ll: Pathophysiology
8
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
8
01:17Hemorrhagic Stroke l: Introduction
8
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
8
01:30Acute Coronary Syndrome III: Diagnostic Studies
492
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
492
01:17Ischemic Heart Disease: Overview
3.8K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
3.8K