Cocaine-induced Stroke in a Section First-time User

Abstract

Cocaine is a widely used recreational drug that functions by inhibiting the reuptake of neurotransmitters in the brain, contributing to feelings of euphoria. Its use can result in stroke primarily through the mechanism of vasospasm, especially in the acute phase. Here, we present a case of a 47-year-old previously healthy male with no family or personal risk factors for stroke, who presented with acute neurological deficits after his first intranasal cocaine use with brain imaging showing scattered areas of restricted diffusion in his left Middle Cerebral Artery (MCA) territory and MCA/Posterior Cerebral Artery (PCA) watershed zone consistent with vasospasm. This case highlights the importance of considering a toxicology screen for cocaine even in the absence of history when working up a young patient presenting with stroke-like symptoms.

Keywords

• cocaine
• first time cocaine use
• headache
• stroke