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Cocaine Use Increases Risk of Hemorrhagic Stroke
SAN FRANCISCO (April 10, 2000)--Cocaine users are found to be more likely to experience a hemorrhagic stroke (sudden bleeding in the brain), at a significantly earlier age and experience poorer outcome after treatment, than non-users. This group represents a portion of the 160,000 Americans who die from strokes each year. The use of cocaine and its adverse effects on the nervous system will be featured at this year's 68th Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), April 8-13, in San Francisco, California.
"Hemorrhagic strokes are much more common in stroke patients with more recent cocaine ingestion," says Anil Nanda, MD, an AANS member from Louisiana, Chairman of the Department of Neurosurgery at Louisiana State University Health Sciences Center and co-author of a recent study on the topic. "Aneurysmal rupture is a direct consequence of the hemodynamic (relating to blood circulation) effects of cocaine."
The study was conducted over six years and focused on the treatment of 16 patients who had acute stroke and who were positively tested for cocaine. Their results were compared with 36 patients of similar ages who were treated during the same time frame for stroke, but who tested negative for cocaine.
Both hemorrhagic and non-hemorrhagic strokes were monitored in this study. Fifty percent of strokes in the cocaine-users group were hemorrhagic compared to 3 percent in the non-cocaine users group. In the United States, about 20 percent of strokes occur from hemorrhage, a sudden bleeding into or around the brain. Stroke occurs when blood flow to the brain is disrupted and brain cells lose their supply of nutrients. This happens when the brain receives too little, or too much, blood.
Victims of hemorrhagic stroke experience a rapid onset of symptoms that evolve over several hours, and include headache, nausea, vomiting and altered states. When the aneurysm ruptures, the victim may experience a terrible headache, neck stiffness, vomiting, confusion and altered states of consciousness.
To combat the aneurysms, all of the patients in the study, except one, received aggressive neurosurgical treatment involving removal of the aneurysms. In the study, 70 percent of patients improved after surgical intervention. An overall good result was achieved in 78 percent of the study group patients and 92 percent of the control group patients. The cases primarily involved patients under the influence of cocaine, who were complaining of severe headaches and neck stiffness.
"Though a direct association is not evident to us, the study does indicate that the combination of the significantly younger age of patients and smaller size of their aneurysms at rupture might suggest an association between cocaine use and the formation/rupture of aneurysms," says Dr. Nanda.
The study also showed that patients with cocaine-related aneurysms reportedly have a higher mortality rate than that of patients with no history of cocaine abuse. The cocaine group had a mortality rate of 50 percent compared to 2.7 percent in the non-cocaine group. Only 31 percent had a good outcome in cocaine users compared to 83 percent in the control group. It is evident that cocaine use appeared to have favored early rupture of these aneurysms at a smaller size and at a younger age, resulting in poorer post-surgery outcome.
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Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons is a scientific and educational association with nearly 5,500 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS must be Board-certified by the American Board of Neurological Surgery. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spine, brain, nervous system and peripheral nerves.
Media Representatives: The Annual Meeting press kit can be found in the Media Center Section of the AANS Web site at: http://www.neurosurgery.org/aans.
If you would like to cover the meeting or interview a neurosurgeon - either on-site or via telephone - please contact the AANS Communications staff at (847) 692-9500 or call the Annual Meeting Press Room beginning Sunday, April 9, at (415) 978-3715 (3716).
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