Complications neurovasculaires aiguës liées à la consommation de la cocaïne, des amphétamines et du cannabis

The acute but also the chronic use of some illicit substances like cocaine, amphetamine derivatives “ecstasy” or cannabis seems to increase the risk in a young population to develop serious cerebrovascular accidents, either hemorrhagic or ischemic. The definitive causal relationship is difficult to establish, since patients usually present other risk factors. Among the possible mechanisms of neurological injury, arterial hypertension as well as vasospasm related to the potent vasoconstrictive properties of some illicit substances may play a significant role. Some patients will also present intracerebral bleeding after the rupture of a preexisting vascular lesion while under the influence of the illicit substance. The functional outcome of patients presenting a stroke after a toxic exposure will likely depend on the severity of the initial injury; in some cases, like in patients presenting aneurysmal subarachnoid hemorrhage, exposure to cocaine may increase the risk of symptomatic vasospasm.