Cocaine-induced massive ischemic stroke treated by decompressive craniectomy with favorable outcome
Hussein Algahtani1, Bader Shirah2, Mubarak Algahtany3, Saeed Alqahtani3, Nawal Abdelghaffar4
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
 Source of Support: None, Conflict of Interest: None  | Check |
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. |