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July 1984

Subarachnoid Hemorrhage Precipitated by Cocaine Snorting

Author Affiliations

Department of Neurology Mount Sinai School of Medicine 1 Gustave Levy PI New York, NY 10029

Arch Neurol. 1984;41(7):705. doi:10.1001/archneur.1984.04050180027008

To the Editor.  —Lichtenfeld et al1 reported two cases of subarachnoid hemorrhage precipitated within minutes, presumably by cocaine snorting. We describe a 23-year-old woman who manifested a severe headache immediately after snorting cocaine.

Report of a Case.  —A 23-year-old woman was admitted to the hospital with a fivehour history of the sudden onset of intense head, neck, and eye pain. The patient had been at a party and, over the course of six hours, she had snorted cocaine approximately 12 times and consumed two mixed drinks (approximately 120 mL of alcohol). Immediately after snorting the cocaine for the 12th time, intolerable pain in the back of her neck and head developed, followed by photophobia.The patient had been snorting cocaine for the past five years with a frequency of about six times per year. She had no prior history of headaches.Examination disclosed a BP of 110/60 mm Hg, a

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