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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(04): 830-834
DOI: 10.4103/ajns.AJNS_104_21
Case Report

Cocaine-induced massive ischemic stroke treated by decompressive craniectomy with favorable outcome

Hussein Algahtani
1   Department of Medicine, King Abdulaziz Medical City
2   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences
3   King Abdullah International Medical Research Center, Jeddah
,
Bader Shirah
2   College of Medicine, King Saud Bin Abdulaziz University for Health Sciences
3   King Abdullah International Medical Research Center, Jeddah
,
Mubarak Algahtany
4   College of Medicine, King Khalid University, Abha
,
Saeed Alqahtani
4   College of Medicine, King Khalid University, Abha
,
Nawal Abdelghaffar
5   Department of Neurology, Faculty of Medicine, Kasr Al Ainy Hospital, Cairo University, Cairo
6   Department of Neurology, Aseer Central Hospital, Abha, Saudi Arabia
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Cocaine abuse is a significant health hazard with multiple cardiac and neurological complications. Cocaine-induced ischemic stroke can have multiple underlying pathophysiological mechanisms, resulting in various complex neurological presentations. We describe a case of a young man who had a massive ischemic multi-territorial stroke who was managed successfully with decompressive craniectomy with a favorable outcome. Cocaine use should be routinely suspected in young patients presenting with ischemic stroke, and a urine toxicology screen should be part of the initial workup for such patients. Brain magnetic resonance imaging is an essential neuroimaging modality, which is very helpful in confirming the ischemic insult and planning management. Early diagnosis and treatment are crucial due to potential reversibility and reduction of the size of infarcted tissue. In addition, multidisciplinary care, including a vascular neurosurgeon, should be implicated.

Key-words:

Cocaine - decompressive craniectomy - ischemic stroke - Saudi Arabia

Financial support and sponsorship

Nil.




Publication History

Received: 09 March 2021

Accepted: 21 August 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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