Cerebrovascular complications of the use of the 'crack' form of alkaloidal cocaine

Article Abstract:

The alkaloidal form of cocaine ('crack'), which appeared commercially in 1983, escalated a situation of drug use that was already epidemic. Cocaine use is known to be associated with cerebrovascular disease, but characterization of cerebrovascular effects associated with crack cocaine has been less extensive. To address this issue, 28 patients with an average age of 34 who had suffered cerebrovascular events (strokes, defined according to specified criteria) within 72 hours of using crack cocaine were studied. Most were black (24 patients) and male (18 patients). Details regarding symptom onset and the patients' medical histories are provided. The most common diagnosis among these patients was cerebral infarction (blockage of an artery that supplies the brain with blood), which was seen in 18 patients, while 10 patients experienced intracranial hemorrhage (bleeding from vessels within the skull). Most of these people had been regular crack users for at least two years before their strokes, although one subject had used it for the first time. Their use of other drugs is documented. Additional data are provided regarding the location of the cerebral damage and the effects of cocaine on the cardiovascular system. Given the nature of the epidemic of crack cocaine use, the occurrence of stroke in a young patient should always be followed by an evaluation of the history of the patient's drug use, as well as by toxicological screening studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Complications and side effects, Stroke (Disease), Stroke, Cocaine abuse, Stroke patients, Crack (Drug)

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Protected Carotid-Artery stenting versus endarterectomy in high-risk patients

Article Abstract:

Stenting with the use of an emboli-protection device is a less invasive revascularization strategy than endarterectomy in carotid-artery disease. The main finding of the randomized trial is that carotid-artery stenting with the use of an emboli-protection device is not inferior to carotid endarter-ectomy in the prevention of stroke, death, or myo-cardial infarction among patients for whom surgery poses an increased risk.

England, Care and treatment, Risk factors, Heart attack, Carotid artery diseases, Endarterectomy

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Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis

Article Abstract:

Patients were randomly assigned with transient ischemic attack or stroke caused by angiographically verified 50 to 99 percent stenosis of a major intracranial artery to receive warfarin in a double-blind multicenter clinical trial. Results revealed warfarin to be associated with significantly higher rates of adverse events and also provided no benefit over aspirin in this trial.

United Kingdom, Science & research, Pharmaceutical Preparation Manufacturing, Pharmaceutical preparations, Aspirin, Aspirin Combinations, Comparative analysis, Warfarin, Arteries, Arterial stenosis

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