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November 1990

Strokes Associated With Cocaine Use-Reply

Author Affiliations

Section of Neurology The Mary Imogene Bassett Hospital One Atwell Rd Cooperstown, NY 13326

Arch Neurol. 1990;47(11):1170. doi:10.1001/archneur.1990.00530110024008

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In Reply.  —We appreciate the skepticism of Drs Tuchman and Daras. In our case, a urine drug screen for cocaine was negative. Thus, a very recent binge would have been unlikely no matter how unreliable the patient's history.So far, we have received one report (G.F. Tegtmeyer, MD, personal communication June 15,1990) of a patient who had used cocaine intranasally 6 months prior to the abrupt onset of headache and ataxia. The patient, who had normal coagulation studies and a normal echocardiogram, was found to have a distal branch occlusion of the superior cerebellar artery on the left side.We recognize that the occurrence of delayed strokes following cocaine abuse would alter and expand our thinking about cocaine and its ill effects. For this reason, we continue to be interested in knowing of other examples of unexplained delayed stroke in young persons with a history of cocaine or other substance abuse.

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