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Cited by 377

The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.

Cerebrovascular Complications of the Use of the Crack Form of Alkaloidal Cocaine

Open access
Levine, Steven R., Brust, John C.M., Futrell, Nancy, Ho, K.-L., Blake, David, Millikan, Clark H., Brass, Lawrence M., Fayad, Pierre, Schultz, Lonni R., Selwa, James F., Welch, K.M.A.·1990·New England Journal of Medicine
DOI 10.1056/nejm199009133231102
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Abstract

BACKGROUND AND METHODS: The use of cocaine, especially one of its alkaloidal forms ("crack"), has been increasingly associated with cerebrovascular disease. To clarify the clinical, radiologic, and pathological features of the events associated with cocaine use, we identified 28 patients at four medical centers who had stroke temporally related to the use of alkaloidal cocaine (during or within 72 hours of use). RESULTS: The 28 patients had the following types of cerebrovascular event: cerebral infarction (n = 18 [2 hemorrhagic; 1 fatal]) in the areas supplied by the middle cerebral artery (n = 10), anterior cerebral artery (n = 3), posterior cerebral artery (n = 1), and vertebrobasilar arteries (n = 4); subarachnoid hemorrhage (n = 5); intraparenchymal hemorrhage (n = 4); and primary intraventricular hemorrhage (n = 1). Eighteen patients (64 percent) had acute neurologic symptoms immediately or within one hour of using cocaine. Fifteen patients (45 percent) with either occlusive or hemorrhagic strokes had sever headache as an early symptom. Vasculitis was not suggested by radiography in any patient, nor was it identified on pathological examination in one patient who died. All the patients were young (mean age, 34 years; range, 23 to 49) and had no other apparent, direct cause of stroke. Other risk factors for stroke among the patients included mild mitral-valve prolapse (n = 4), hypertension (n = 4), cigarette smoking (n = 8), and regular alcohol use (n = 6). CONCLUSIONS: There is a strong temporal association of the use of alkaloidal cocaine with both ischemic and hemorrhagic cerebrovascular events. Cocaine-related stroke probably has many causes. A thorough history focusing on the use of cocaine and toxicologic screening of urine and serum should be part of the evaluation of any young patient with a stroke.

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Crossref · 10.1056/nejm199009133231102

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Metadata

Authors
Levine, S. R., Brust, J. C. M., Futrell, N., Ho, K.-L., Blake, D., Millikan, C. H., Brass, L. M., Fayad, P., Schultz, L. R., Selwa, J. F., & Welch, K. M. A.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1990-09-13
Volume
323
Issue
11
Pages
699-704
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199009133231102
OpenAlex
W1980647471
Cited by
377
References
38
FWCI
14.34
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Cerebrovascular Complications of the Use of the Crack Form of Alkaloidal Cocaine. https://app.cochat.ai/papers/10.1056/nejm199009133231102
The paper
Levine, S. R., Brust, J. C. M., Futrell, N., Ho, K.-L., Blake, D., Millikan, C. H., Brass, L. M., Fayad, P., Schultz, L. R., Selwa, J. F., & Welch, K. M. A. (1990). Cerebrovascular Complications of the Use of the Crack Form of Alkaloidal Cocaine. New England Journal of Medicine. https://doi.org/10.1056/nejm199009133231102

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.