Subcortical cerebral hemorrhages associated with cocaine abuse: CT and MR findings.

Four young individuals with histories of heavy cocaine abuse occurring several hours to days before the development of acute symptoms of severe headaches, disorientation, and subsequent stupor were shown to harbor subcortical cerebral hemorrhages. Thorough workup of these patients revealed no underlying pathology (i.e., arteriovenous malformations) or other possible causes such as hemorrhage into a tumor. It is well known that heroin, ephedrine, and methamphetamine use may result in cerebral vasculitis, but only one case study in the literature has reported on cerebral vasculitis with ischemic stroke secondary to cocaine abuse. The possibility of heavy cocaine use should be considered, along with the previously mentioned drugs, when a young, previously healthy person presents with a deep cerebral hemorrhage.