Delayed cerebral ischemia causing cortical blindness due to repeat cocaine use weeks subsequent to aneurysmal subarachnoid hemorrhage.

Autor:	Klein BJ; Carilion Clinic, Section of Neurosurgery, 1906 Belleview Ave, Roanoke, VA 24014, USA.; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Virginia Tech School of Neuroscience, 300 Turner Street NW, Blacksburg, VA 24061, USA., Cuoco JA; Carilion Clinic, Section of Neurosurgery, 1906 Belleview Ave, Roanoke, VA 24014, USA.; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Virginia Tech School of Neuroscience, 300 Turner Street NW, Blacksburg, VA 24061, USA., Rogers CM; The University of Texas MD Anderson Cancer Center, Department of Neurosurgery, Houston, TX, USA., Entwistle JJ; Carilion Clinic, Section of Neurosurgery, 1906 Belleview Ave, Roanoke, VA 24014, USA.; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Virginia Tech School of Neuroscience, 300 Turner Street NW, Blacksburg, VA 24061, USA., Marvin EA; Carilion Clinic, Section of Neurosurgery, 1906 Belleview Ave, Roanoke, VA 24014, USA.; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Virginia Tech School of Neuroscience, 300 Turner Street NW, Blacksburg, VA 24061, USA., Patel BM; Carilion Clinic, Section of Neurosurgery, 1906 Belleview Ave, Roanoke, VA 24014, USA.; Virginia Tech Carilion School of Medicine, 2 Riverside Circle, Roanoke, VA 24016, USA.; Virginia Tech School of Neuroscience, 300 Turner Street NW, Blacksburg, VA 24061, USA.; Carilion Clinic, Neurointerventional Surgery, Department of Radiology, Roanoke, VA, USA.
Jazyk:	angličtina
Zdroj:	Radiology case reports [Radiol Case Rep] 2020 Jul 03; Vol. 15 (9), pp. 1455-1459. Date of Electronic Publication: 2020 Jul 03 (Print Publication: 2020).
DOI:	10.1016/j.radcr.2020.05.050
Abstrakt:	Cocaine is a known vasoactive drug associated with poor clinical outcomes and high in-hospital mortality related to aneurysmal subarachnoid hemorrhage; however, the association of prior cocaine use with the incidence of vasospasm and delayed cerebral ischemia remains controversial. We report a case of a 42-year-old male with a history of active cocaine use who presented with a severe headache. Imaging demonstrated diffuse cisternal subarachnoid hemorrhage due to a ruptured basilar apex aneurysm, which was successfully treated with endovascular coil embolization. Despite expedited endovascular treatment and an initially benign clinical course, he suffered from delayed cerebral ischemia resulting in cortical blindness due to bilateral posterior cerebral artery vasospasm secondary to repeat cocaine use weeks after his initial ictus. To our knowledge, the present case is the first to describe delayed cerebral ischemia resulting in a severe neurologic deficit due to repeat cocaine use weeks subsequent to aneurysm rupture. We review the current literature on the association of cocaine use with the incidence of vasospasm and delayed cerebral ischemia as well as the effects of cocaine on the cerebrovasculature. (© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
Databáze:	MEDLINE
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