EMBOLIC STROKE AFTER SMOKING CRACK COCAINE

A 39-year-old woman had an embolic upper division middle cerebral artery branch occlusion 3 hours after smoking the free base of cocaine (“crack”). Radionuclide ventriculography demonstrated cardiomyopathy, and echocardiography documented a left atrial thrombus. This case demonstrates that embolism is one mechanism of ischemic stroke after cocaine use, and that cardiomyopathy, possibly cocaine induced, may be the source of em bolus. A cardiac source of em bolus should be sought in patients with cocaine-associated cerebral infarction. © 1990 American Heart Association, Inc.