Abstract
IntroductionIn the United States, cocaine is a commonly used drug of abuse. It is also a recognized contributing factor for both hemorrhagic and ischemic strokes. However, cocaine-induced basilar artery thrombosis has rarely been reported in the literature.Case presentationOur patient was a 51-year-old African American woman with a history of polysubstance abuse who presented to the emergency department for acute behavior changes. Later, during admission, she had a dramatic decrease in motor strength in all extremities and a positive Babinski reflex bilaterally. The results of her toxicology reports were positive for cocaine; in addition, results of magnetic resonance angiography and magnetic resonance imaging were consistent with acute thrombosis and subsequent infarction of the basilar artery. Her mental status improved, but she was only able to communicate via movements of her eyes.ConclusionOur patient developed locked-in syndrome after use of cocaine. Given the prevalence of its use in the United States, cocaine use should be included among the potential causes of locked-in syndrome.
Highlights
ConclusionOur patient developed locked-in syndrome after use of cocaine. Given the prevalence of its use in the United States, cocaine use should be included among the potential causes of locked-in syndrome
In the United States, cocaine is a commonly used drug of abuse
Given the prevalence of its use in the United States, cocaine use should be included among the potential causes of locked-in syndrome
Summary
We suggest that the usual clinical manifestations of LIS can result from cocaine use and, importantly, that cocaine use should be included among the potential causes of LIS. This case report illustrates the need for routine investigation by obtaining a urine toxicology screen for all patients with altered mental status and the importance of awareness of the serious complications of cocaine use
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