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Cocaine-associated intracranial hemorrhage

Absence of vasculitis in 14 cases

From the Center for Stroke Research, Departments of Neurology (Drs. Aggarwal, Williams, and Levine) and Pathology (Neuropathology) (Dr. Garcia), Henry Ford Health Sciences Center/Case Western Reserve University; and the Wayne County Medical Examiner's Office (Dr. Cassin), Detroit, MI.
Supported in part by National Institutes of Health grant NS23393; a grant-in-aid from the American Heart Association (Michigan Affiliate); and a Cerebrovascular Disease Student Fellowship award (to V.W.) from the American Heart Association, Dallas, TX.
Received April 28, 1995. Accepted in final form October 19, 1995.
Address correspondence and reprint requests to Dr. Steven R. Levine, Center for Stroke Research, Department of Neurology (K-11), Henry Ford Hospital and Health Science Center, 2799 West Grand Blvd, Detroit, MI 48202-2689.

Complications associated with the use of cocaine are varied, and include cerebral hemorrhage and ischemia, with vasculitis and vasospasm as possible etiologies.We reviewed selected brain samples from 14 autopsy cases of cocaine-related cerebrovascular disease. Intracerebral or subarachnoid hemorrhage was present in 12 cases. Intracranial arterioles were either normal or showed nonspecific changes. From these observations, we suggest that intracranial hemorrhages occur in the absence of readily detectable vascular abnormalities.

NEUROLOGY 1996;46: 1741-1743

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