[Cocaine-induced brain stem stroke associated to craneal midline destructive lesions]. / Ictus de tronco asociado a lesiones destructivas de línea media craneal inducidas por cocaína.

INTRODUCTION: Abuse of cocaine and other sympathomimetic drugs has been reported as a significant risk factor for stroke. The physiopathologic mechanisms implicated are multifactorial. Chronic cocaine use leads to extensive destruction of osteocartilaginous structures of nose, sinuses and palate. CASE REPORT: We report the case of a 56 years-old woman with hypertension and smoke abuse who was admitted with a pontine paramedian infarction. Cranial resonance findings of midline destructive lesions lead to the suspicion of chronic cocaine consumption. The initial outcome was good but she was re-admitted nine months later with an extent pontomesencephalic infarction. CONCLUSIONS: Abuse of cocaine is a risk factor for stroke that should be considered not only in young patients. The pathogenic relationship between stroke and midline cocaine related destructive lesions is discussed.

Ictus de tronco asociado a lesiones destructivas de línea media craneal inducidas por cocaína / Cocaine-induced brain stem stroke associated to craneal midline destructive lesions

Introducción. La asociación entre enfermedad cerebrovascular y consumo de cocaína y otras drogas simpaticomiméticas ha sido ampliamente reflejada en la literatura y son múltiples los mecanismos fisiopatológicos que pueden explicar esta asociación. Por otro lado, el consumo crónico de cocaína produce lesiones destructivas de estructuras osteocartilaginosas de nariz, senos nasales y paladar. Caso clínico. Se describe el caso de una paciente de 56 años, hipertensa y fumadora que ingresa por un infarto pontino paramediano y en la que fue el hallazgo en neuroimagen de lesiones destructivas de línea media craneal lo que hizo sospechar el consumo crónico de cocaína. Tras una evolución inicial satisfactoria, sufrió una recurrencia a los 9 meses en forma de extenso infarto pontomesencefálico. Conclusiones. El consumo de cocaína debe tenerse en cuenta como factor de riesgo de enfermedad cerebrovascular, no sólo entre la población joven. Discutimos la relación fisiopatológica entre las lesiones destructivas de línea media craneal y los infartos de tronco recurrentes

Introduction. Abuse of cocaine and other sympathomimetic drugs has been reported as a significant risk factor for stroke. The physiopathologic mechanisms implicated are multifactorial. Chronic cocaine use leads to extensive destruction of osteocartilaginous structures of nose, sinuses and palate. Case report. We report the case of a 56 years-old woman with hypertension and smoke abuse who was admitted with a pontine paramedian infarction. Cranial resonance findings of midline destructive lesions lead to the suspicion of chronic cocaine consumption. The initial outcome was good but she was re-admitted nine months later with an extent pontomesencephalic infarction. Conclusions. Abuse of cocaine is a risk factor for stroke that should be considered not only in young patients. The pathogenic relationship between stroke and midline cocaine related destructive lesions is discussed