Cocaine-Induced Intracerebral Hemorrhage in a Patient with Cerebral Amyloid Angiopathy

• NCJ Number: 232596
• Journal: Journal of Forensic Sciences Volume: 55 Issue: 5 Dated: September 2010 Pages: 1389-1392
• Author(s): Marianna Shvartsbeyn, M.D.; Daniel G. K. Phillips, M.D.; Michael A. Markey, M.D.; Alan Morrison, M.D.; Joyce L. DeJong, M.D.; Rudy J. Castellani, M.D.
• Date Published: September 2010
• Length: 4 pages
• Publication Format: Article
• Publication Type: Case Study
• Language: English
• Country: United States of America

Annotation

This article reports a case of a 62-year-old woman who suffered left parieto-occipital ICH (intracerebral hemorrhage) with herniation and death, following a cocaine binge.

Abstract

Intracerebral hemorrhage (ICH) is a well-recognized complication of recreational cocaine use. The precise mechanism of the cocaine-induced hemorrhagic event is unclear, although multiple factors have been implicated. Microscopic examination also revealed extensive cerebral amyloid angiopathy (CAA) in the vicinity of the hemorrhage. The authors additionally studied brain tissue in eight subjects between ages of 60 and 80 who were positive for cocaine metabolites at autopsy; of these, none had vascular amyloid- deposits by immunohistochemistry. Whereas the investigation found no evidence that chronic cocaine use is a risk factor for CAA, given the age-associated nature of CAA and the aging population using cocaine, CAA-induced hemorrhage in the setting of cocaine use may be more common than recognized. This is the first reported case of CAA-associated ICH precipitated by cocaine. (Published Abstract)