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49 - STROKE AND SUBSTANCE ABUSE

from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM

Published online by Cambridge University Press:  06 January 2010

By
John C. M. Brust
Edited by
Louis R. Caplan  and
Julien Bogousslavsky
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Julien Bogousslavsky
Affiliation:
Valmont Clinique, Glion, Switzerland
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Summary

This chapter explores the complex relationship of stroke with the usage of abusive drugs. Opiates, amphetamines, cocaine, D-lysergic acid diethylamide (LSD), marijuana, sedatives, ethanol, tobacco and phencyclidine are investigated. Hemorrhagic stroke in heroin users may be a consequence of hepatitis with liver failure and deranged clotting or of heroin nephropathy with uremia or malignant hypertension. Amphetamine-induced cerebral vasculitis has also caused ischemic stroke. Cocaine increases the likelihood of vasospasm after aneurysm rupture. D-lysergic acid diethylamide (LSD), phencyclidine and marijuana users reports symptoms of stroke. Barbiturates, benzodiazepines, and other sedative drugs can cause cerebral infarction whereas hemorrhagic stroke has not otherwise been reported. Aneurysmal rupture occurred during orgasm following amyl nitrite inhalation. Multiple mechanisms probably explain the complex association of ethanol and stroke. Smoking is a major risk factor for coronary artery and peripheral vascular disease. Tobacco increases the risk for both ischemic and hemorrhagic stroke.

Keywords

coagulation factorsdifferential diagnosisdisseminated intravascular diseasereplacement therapytissue factor plasma inhibitorsthrombin inhibitorsstrokeschistocytes
Type
Chapter
Information
Uncommon Causes of Stroke , pp. 365 - 370
Publisher: Cambridge University Press
Print publication year: 2008

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