Central nervous system angiopathy associated with cocaine abuse

Cocaine abuse has been associated with various cerebrovascular complications, including vasculitis. We describe a patient who presented with neurologic defects associated with cocaine abuse. Although angiography raised the suggestion of vasculitis, biopsy revealed a lack of inflammatory changes, and other aspects of the clinical course also militated against inflammatory vasculitis. This case was reminiscent of recently described patients initially suspected of having primary central nervous system (CNS) vasculitis but subsequently considered to have "benign angiopathy." We suggest that benign angiopathy of the CNS can occur as a result of cocaine abuse.