Cocaine-induced vasospasm causing spinal cord transient ischemia.

A 25-year-old woman developed a spinal cord infarction leading to quadriplegia and respiratory insufficiency after consuming cocaine and vodka for several days. Within five months, she regained full motor and respiratory function. A literature review revealed 11 cases of cocaine-induced spinal cord infarction. A complete recovery from quadriplegia and respiratory failure following cocaine abuse has never been reported to date. The value of diffusion-weighted imaging in cocaine-induced spinal cord infarction is here presented and discussed. The literature proposes several mechanisms for cocaine-induced infarction including vasospasm, arteritis, and thrombosis. In this case, the imaging studies and the full recovery suggest that the spinal cord ischemia was secondary to a transient vasospasm of the anterior spinal artery.