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NEUROLOGY 1986;36:1602
© 1986 American Academy of Neurology

Cerebral infarction in a user of free-base cocaine ("crack")

Lawrence I. Golbe, MD and Michael D. Merkin, MD

Department of Neurology, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ.

After smoking "crack," the free-base form of cocaine, a 27-year-old man suffered an infarction of most of the territory of the right middle cerebral artery. Concomitant drug use seemed to have been limited to ethanol and ibuprofen. Search for other possible causes was negative. Angiography revealed narrowing of the supraclinoid portion of the right internal carotid artery (ICA) and cutoff of at least two distal branches. There was no beading or irregularity to suggest vasculitis. Crack may have induced vasospasm in the ICA through recognized sympathomimetic actions of cocaine.

Address correspondence and reprint requests to Dr. Golbe, Department of Neurology, CN-19, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903.

Accepted for publication October 3, 1986.




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