Year: 2023
Type: conference-abstract
Abstract: Introduction: Cocaine is among the most commonly used illicit recreational drugs worldwide, and its abuse significantly increases the risk of ischemic stroke. Preclinical studies have indicated that cocaine may stimulate arterial dissection, during which blood enters the arterial wall through an intimal tear and activates the coagulation cascade at the site of endothelial damage. This is a case report of a patient, who presented an ischemic stroke, with a history of cocaine abuse in the last 24 hours. The article was developed from data collection through literature review on the subject, as well as analysis of the patient’s medical records. Case report: A 28-year-old man with a history of previously healthy, with a report of cocaine abuse in the last 24 hours, found unconscious on a public road and upon waking up he had aphasia and right hemiplegia, scoring NIHSS 18. Patient was investigated with brain resonance which showed an extensive acute ischemic infarction compromising the frontal, temporal, insula and basal ganglia regions on the left. The etiological investigation discarded the hypothesis of a cardioembolic and/or autoimmunity phenomenon. The arteriography showed an occlusion of the internal carotid artery at its origin with an aspect of arterial dissection. Conclusion: Cocaine-induced dissection of various arteries has been described in the literature, leading to cardiac and neurological complications. The combination of hypertension and intense vasoconstriction result in shear stress on the arterial wall, which may lead to atherosclerotic plaque rupture in those with vascular disease, and an increased risk of dissection even in those with normal arteries, as was the case with our patient. Therefore, public policies against drugs are also means of preventing strokes, especially in the younger population.
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W4384079190