Cerebral Vasculitis Associated With Cocaine Abuse or Subarachnoid Hemorrhage?

Abstract

To the Editor. —I read with interest the recent article by Kaye and Fainstat.1I would like to describe a patient who developed white-matter disease apparently related to long-term cocaine abuse. To my knowledge, this hazard of cocaine abuse has not been reported previously. Report of a Case. —A 27-year-old man presented with a left-sided seizure. During the past few weeks, he had noticed heaviness and paresthesias in his lower extremities and periods of forgetfulness. His medical history was unremarkable except for occasional intranasal use of cocaine during the past five years. He denied intravenous drug or alcohol abuse and there was no history of cardiac or collagen vascular disease. Examination disclosed the following values: blood pressure, 110/60 mm Hg; pulse rate, 88 beats per minute; and respirations, 18/min. He was alert, oriented, and without focal neurological findings. Contrast-enhanced computed tomographic scans of the head were normal (Fig 1).