Neurological complications of drug abuse: pathophysiological mechanisms

Neiman, Jack; Haapaniemi, H M; Hillbom, Matti

doi:10.1046/j.1468-1331.2000.00045.x

Cited by 159 publications

(87 citation statements)

References 137 publications

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“…522 These drugs can produce acute and severe BP elevation, cerebral vasospasm, vasculitis, embolization due to infective endocarditis, hemostatic and hematologic abnormalities resulting in increased blood viscosity and platelet aggregation, and ICH. [523][524][525][526][527][528] Information about stroke-related drug abuse is mainly limited to epidemiological studies focused on urban populations. There is an increase in the risk of both ischemic and hemorrhagic stroke.…”

Section: Drug Abusementioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,300

577

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Background and Purpose-This guideline provides an overview of the evidence on established and emerging risk factors for stroke to provide evidence-based recommendations for the reduction of risk of a first stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council Scientific Statement Oversight Committee and the AHA Manuscript Oversight Committee. The writing group used systematic literature reviews (covering the time since the last review was published in 2006 up to April 2009), reference to previously published guidelines, personal files, and expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulate recommendations using standard AHA criteria (Tables 1 and 2). All members of the writing group had the opportunity to comment on the recommendations and approved the final version of this document. The guideline underwent extensive peer review by the Stroke Council leadership and the AHA scientific statements oversight committees before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Schemes for assessing a person's risk of a first stroke were evaluated. Risk factors or risk markers for a first stroke were classified according to potential for modification (nonmodifiable, modifiable, or potentially modifiable) and strength of evidence (well documented or less well documented). Nonmodifiable risk factors include age, sex, low birth weight, race/ethnicity, and genetic predisposition. Well-documented and modifiable risk factors include hypertension, exposure to cigarette smoke, diabetes, atrial fibrillation and certain other cardiac conditions, dyslipidemia, carotid artery stenosis, sickle cell disease, postmenopausal hormone therapy, poor diet, physical inactivity, and obesity and body fat

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Section: Drug Abusementioning

confidence: 99%

Guidelines for the Primary Prevention of Stroke

Goldstein¹,

Bushnell²,

Adams³

et al. 2011

Stroke

1,300

577

View full text Add to dashboard Cite

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“…Chronic cocaine abuse is associated with cerebrovascular dysfunction which may contribute to significant neuropathology (Bruno, 2003;Neiman et al, 2000). Recent magnetic resonance (MR) imaging studies have provided strong evidence that cocaine abuse is associated with structural brain abnormalities in both gray matter (GM) and white matter (WM) (Bartzokis et al, 2002;Fein et al, 2002;Franklin et al, 2002;Lim et al, 2002;Moeller et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Brain macrostructural and microstructural abnormalities in cocaine dependence

Lim

Wozniak

Mueller

et al. 2008

Drug and Alcohol Dependence

145

115

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Rationale-Two previous studies have utilized Diffusion Tensor Imaging (DTI) to examine microstructural integrity in cocaine abuse and found evidence of brain abnormalities in white matter.Objective-Using anatomical magnetic resonance imaging (MRI), DTI, and clinical evaluation, the macrostructural and microstructural correlates of cocaine abuse were investigated.Methods-21 men and women (mean age 42.5, mean 18.9 years of cocaine use) and 21 age/gendermatched controls were included. Fractional anisotropy (FA) was measured in frontal white matter ROIs. Gray and white matter volumes in superior and inferior frontal regions were compared.Results-DTI data revealed that cocaine users had lower FA than controls, specifically in inferior frontal white matter. FA differences were not seen in other areas. Significant volumetric differences were not seen, but both grey and white matter inferior frontal volumes trended toward smaller in the cocaine group. The data suggested that duration of use was associated with decreased grey and white matter volumes. FA and grey matter volume were correlated in cocaine users.Conclusions-Both macrostructural and microstructural abnormalities were seen in a group of cocaine abusers. Length of cocaine use was associated with severity of the brain abnormalities. Future studies of white matter tissue integrity are warranted including examination of the relationship between DTI measures and traditional volumetric measures.

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“…Cocaine has been recognized as a significant risk factor for ICH and ischemic stroke (infarct) [9] in general populations. However, there is discrepancy in studies on cocaine related to CVD in gender, age, and race.…”

Section: Resultsmentioning

confidence: 99%