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首页> 外文期刊>Radiology Case Reports >Delayed cerebral ischemia causing cortical blindness due to repeat cocaine use weeks subsequent to aneurysmal subarachnoid hemorrhage
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Delayed cerebral ischemia causing cortical blindness due to repeat cocaine use weeks subsequent to aneurysmal subarachnoid hemorrhage

机译：由于动脉瘤蛛网膜下腔出血后的重复可卡因而导致皮质失明引起皮质失明的延迟脑缺血

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摘要

Cocaine is a known vasoactive drug associated with poor clinical outcomes and high in-hospital mortality related to aneurysmal subarachnoid hemorrhage; however, the association of prior cocaine use with the incidence of vasospasm and delayed cerebral ischemia remains controversial. We report a case of a 42-year-old male with a history of active cocaine use who presented with a severe headache. Imaging demonstrated diffuse cisternal subarachnoid hemorrhage due to a ruptured basilar apex aneurysm, which was successfully treated with endovascular coil embolization. Despite expedited endovascular treatment and an initially benign clinical course, he suffered from delayed cerebral ischemia resulting in cortical blindness due to bilateral posterior cerebral artery vasospasm secondary to repeat cocaine use weeks after his initial ictus. To our knowledge, the present case is the first to describe delayed cerebral ischemia resulting in a severe neurologic deficit due to repeat cocaine use weeks subsequent to aneurysm rupture. We review the current literature on the association of cocaine use with the incidence of vasospasm and delayed cerebral ischemia as well as the effects of cocaine on the cerebrovasculature.
机译：可卡因是一种已知的血管活性药物，与临床结果不佳，与动脉瘤性蛛网膜膜瘤出血有关的临床结果差和高入院死亡率;然而，先前可卡因与血管痉挛发病率和延迟脑缺血的协会仍存在争议。我们举报了一个42岁男性的案例，患有严重头痛的活性可卡因历史。成像由于破裂的基底尖端动脉瘤而展示弥漫性剖腹产镜蛛网膜瘤出血，其用血管内卷线栓塞成功处理。尽管加速血管内治疗和最初的良性临床课程，但他患有延迟的脑缺血，导致皮质失明导致皮质失明，由于双侧后脑动脉血管痉挛，其在其最初的ICTUS后几周重复可卡因。据我们所知，本案例是第一个描述延迟脑缺血导致严重的神经系统缺陷导致由于在动脉瘤破裂之后重复的可卡因使用数周使用的严重神经系统缺陷。我们审查了当前关于可卡因协会的文献与血管痉挛发病率和延迟脑缺血以及可卡因对脑血管结构的影响。

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