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Neurol Sci (2008) 29:S269S270 DOI 10.1007/s10072-008-0960-z
ANNUAL MEETING OF SIN/SNO LOMBARDIA
Drug abuse and intracranial hemorrhage
Mario Pozzi Daria Roccatagliata Roberto Sterzi
Springer-Verlag 2008
Abstract The rate of strokes among amphetamine and cocaine abusers is increasing. The exact mechanism remains unclear. Many factors could be involved including vasospasm, cerebral vasculitis, enhanced platelet aggregation, cardioembolism, and hypertensive surges. Around 40% of patients have pre-existing lesions (aneurysms, artero-venous malformations). Cerebral angiographic examination is recommended in cases of cocaine-related intracerebral hemorrhage, especially if the hemorrhage is lobar or intraventricular.
Keywords Intracranial hemorrhage Cocaine Amphetamine
One of the lessons of the week of the British Medical Journal, published some years ago, was dedicated to Intracerebral hemorrhage in young adults: the emerging importance of drug misuse [1]. In fact, the spreading misuse of cocaine, amphetamines, and ecstasy among young people had modified the list of the traditional etiological factors for hemorrhagic stroke. However, doctors must be aware that it is difficult to link any neurological event with use of a particular drug. This is in fact a clinical challenge because patients may give inaccurate histories or because the substances bought on the street are frequently mixed with a variety of compounds.
The first report of an association with cerebral hemorrhage was in 1945 for amphetamine [2] and in 1977 for cocaine [3]. Since the diffusion of alkaloidal crack in the early 1980s,...