Drug abuse and intracranial hemorrhage.

The rate of strokes among amphetamine and cocaine abusers is increasing. The exact mechanism remains unclear. Many factors could be involved including vasospasm, cerebral vasculitis, enhanced platelet aggregation, cardioembolism, and hypertensive surges. Around 40% of patients have pre-existing lesions (aneurysms, artero-venous malformations). Cerebral angiographic examination is recommended in cases of cocaine-related intracerebral hemorrhage, especially if the hemorrhage is lobar or intraventricular.