Abstract
Introduction: There are several pathogenic mechanisms that have been theorized for cocaine-related ischemic strokes (CRIS). However, there are limited studies to date that have classified them under a subtype of the Trial of ORG 10127 in Acute Stroke Treatment (TOAST) criteria. This study aims to describe CRIS by the TOAST criteria, treatment, and clinical outcomes. Methods: A retrospective chart review was performed at our comprehensive stroke center from 2020-2022 to identify patients with acute ischemic stroke (AIS) with a cocaine-positive status on admission. Baseline demographics, urine toxicology, National Institute of Health Stroke Scale (NIHSS) scores, neuroimaging, TOAST criteria, location of stroke, home medications, comorbidities, medical management, and inpatient outcomes including modified Rankin Score (mRS) were reported. Results: A total of 74 patients were identified to have a positive cocaine status on admission with a diagnosis of new AIS from 2020-2022. The mean age was found to be 60.8 years old with a majority male population at 73.0%. Seventy-eight percent were found to be cocaine positive on admission via urine toxicology with the remaining endorsing a history of cocaine use. The most common category under the TOAST criteria was large artery atherosclerosis (39.2%). Among the cocaine-positive cohort, 10.8% of patients received thrombolytics and 18.9% underwent endovascular thrombectomy. The majority of patients had intracranial atherosclerotic disease (62.2%) on imaging and in the area of the stroke (55.4%). Overall mortality was low (97.3% alive) and modified Rankin score (mRS) at discharge was less than 3 for 59.5% of patients. Conclusion: Our data suggests that CRIS may have a higher association with large artery atherosclerosis. This study highlights the importance of future larger studies to investigate atherosclerosis as a contributor to cocaine-induced ischemic strokes.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
