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CASE REPORT
Year : 2021  |  Volume : 16  |  Issue : 4  |  Page : 830-834

Cocaine-induced massive ischemic stroke treated by decompressive craniectomy with favorable outcome


1 Department of Medicine, King Abdulaziz Medical City; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
2 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3 College of Medicine, King Khalid University, Abha, Saudi Arabia
4 Department of Neurology, Aseer Central Hospital, Abha, Saudi Arabia; Department of Neurology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt

Correspondence Address:
Dr. Hussein Algahtani
King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, P.O. Box: 12723, Jeddah, 21483
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_104_21

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Cocaine abuse is a significant health hazard with multiple cardiac and neurological complications. Cocaine-induced ischemic stroke can have multiple underlying pathophysiological mechanisms, resulting in various complex neurological presentations. We describe a case of a young man who had a massive ischemic multi-territorial stroke who was managed successfully with decompressive craniectomy with a favorable outcome. Cocaine use should be routinely suspected in young patients presenting with ischemic stroke, and a urine toxicology screen should be part of the initial workup for such patients. Brain magnetic resonance imaging is an essential neuroimaging modality, which is very helpful in confirming the ischemic insult and planning management. Early diagnosis and treatment are crucial due to potential reversibility and reduction of the size of infarcted tissue. In addition, multidisciplinary care, including a vascular neurosurgeon, should be implicated.


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