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Stroke related to cocaine use

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Definition:

Stroke is a loss of brain function due to an interruption of the brain's blood supply. It can be caused by using the illegal drug cocaine.

Causes, incidence, and risk factors:

Cocaine is a product of the coca plant and is an illegal recreational drug. It is not a narcotic (a drug which causes drowsiness and sleep, typically heroin or other opiates) although it is sometimes referred to as one.

Cocaine is a strong stimulant, which produces increased activity of the central nervous system   and the peripheral nervous system (the nerves that run away from the spinal cord).

Cocaine can be taken into the body in several ways and in several forms. Powdered cocaine (hydrochloride) can be snorted, injected, eaten, or applied to mucus membranes such as the vagina or rectum. The "freebase" form (often called crack) can be smoked.

The amount of cocaine required to produce an effect varies with the individual, the purity of the drug, and the means of taking it into the body. A smaller amount is used with injection into a vein or with smoking.

Cocaine use can cause a number of medical problems, including transient ischemic attacks ( TIA ), strokes, cardiovascular (heart and blood vessels) collapse, irregular heartbeats, and heart attacks . Stroke secondary to cocaine probably occurs because cocaine causes blood vessels to narrow (constrict) while also increasing blood pressure ( hypertension ). This 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 developing a stroke. In these cases the stroke is due to bleeding in the brain as opposed to decreased blood flow.

Cocaine use can also lead to lung damage from smoking, damage to veins, transmission of blood-borne diseases (due to dirty needles), damage to a unborn baby, and very high body temperatures(hyperthermia). Cocaine also causes mood swings, delirium , migraine-type headaches, and seizures .

Although it does not produce the dramatic withdrawal symptoms seen in heroin addiction, cocaine is extremely addictive and users who stop may experience severe drug craving, depression, and lethargy.

References:

Egred M, Davis GK. Cocaine and the heart. Postgrad Med J . 2005 Sep;81(959):568-71. Review.

Velasquez EM, Anand RC, Newman WP 3rd, Richard SS, Glancy DL. Cardiovascular complications associated with cocaine use. J La State Med Soc . 2004 Nov-Dec;156(6):302-10; quiz 311. Review.

Lucas CE. The impact of street drugs on trauma care. J Trauma. 2005 Sep;59(3 Suppl):S57-60; discussion S67-75.

• Review Date: 4/28/2006
• Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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