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Stroke related to cocaine use

• Overview
• Symptoms
• Treatment
• Prevention

Treatment:

Treatment of stroke secondary to cocaine may be complicated by the need to treat the stroke, other disorders that may occur from the use of cocaine, and the need to treat any symptoms of withdrawal from cocaine such as drug craving, lethargy, and depression.

The person may be in a coma . There may be a need for life support, including placement of tubes into the airway and artificial ventilation (breathing assistance, breathing machines).

All use of cocaine must be stopped. Since most cocaine addicts are also addicted to other drugs (such as alcohol or heroin), symptoms of withdrawal from these drugs should also be looked for and treated as appropriate. Patients on methadone maintenance for heroin addiction should continue to receive their regular dose.

Heart arrhythmias (irregular beats) are treated with antiarrhythmic drugs or other medications.

Other conditions should be treated as appropriate.

The person should be continually observed for signs of cocaine withdrawal. Dopamine agonist medications may reduce symptoms of withdrawal from cocaine. Amantadine has been found to help reduce the risk of relapse in the most severely addicted patients. Sedatives, such as diazepam and midazolam, may be of some benefit in reducing agitation and insomnia. Plans for treatment of cocaine addiction and other addictions if present should be made if appropriate.

Expectations (prognosis):

The outcome depends on the severity of the stroke, any other conditions that may be present, and withdrawal symptoms. The outcome is often poor, especially if the cocaine has been excessively used for a long time. Death caused by collapse of multiple body systems can occur.

Complications:

See Stroke .

Calling your health care provider:

Go to the emergency room or call 911 if you have any symptoms of stroke.

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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