Cocaine-induced ischemic cerebral infarction mistaken for a psychiatric syndrome

We present the case of a 39-year-old woman who developed an ischemic cerebral infarction after using cocaine. Initially the patient was thought to suffer from a psychiatric disorder, and a computed tomography (CT) scan at the time of admission was entirely normal. Further evaluation of the patient by staff on the Psychiatric Unit led to the suspicion that she had suffered a stroke. A repeat CT scan on the third hospital day showed a large infarction in the left middle cerebral artery territory. We discuss the diagnosis of cerebral infarction with subtle presentations due to cocaine use.