Stroke secondary to cocaine

Definition:

A brain disorder caused by the use or abuse of cocaine, involving loss of brain functions because of interruption of the brain's blood supply.

Causes, incidence, and risk factors:

Cocaine is a product of the coca plant and is a well-known drug involved in illicit (illegal or not medically prescribed) drug use. It is not a narcotic drug. It is a stimulant, causing increased activity of the central nervous system (associated with the brain and spinal cord) and the peripheral nervous system (the rest of the body). It is taken into the body in several forms, such as by smoking, snorting, ingesting (eating), or injecting. The amount required to produce an effect varies with the individual, with the purity of the drug, and with the means of taking it into the body. A smaller amount is usually required with injection into a vein or with smoking.

Use of cocaine has been associated with many medical conditions, including cardiovascular (heart and blood vessel) collapse, irregular heartbeats, heart attack, lung damage, damage to a fetus, and very high temperature elevations. Cocaine also causes mood swings, delirium, migraine-type headaches, seizures, transient ischemic attacks (TIA), and strokes. Stroke secondary to cocaine probably occurs because cocaine causes blood vessels to constrict (narrow) with an associated increase in blood pressure (hypertension). The vasoconstriction can be severe enough to reduce or block blood flow through the arteries in the brain.

Stroke secondary to cocaine is most common in men under 40 years old. Risks include a history of recent cocaine use. In a few people who experience stroke after using cocaine, an underlying arteriovenous malformation is found, which may have predisposed them to stroke.