Key result
In a cohort of 74 patients with cocaine-related acute ischemic stroke, 39.2% of strokes were attributed to large-artery atherosclerosis, suggesting a higher association than previously understood.
Why the study?
Few studies have confirmed the unique stroke mechanisms associated with acute and chronic cocaine use, and the safety of combination thrombolytic therapy and endovascular thrombectomy in these patients has not been well studied.
Cohort (n=74)
No
Cocaine-related ischemic strokes may have a higher association with large artery atherosclerosis than previously understood, challenging the historical view that vasospasm and small vessel occlusion are the primary mechanisms.
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Supports cocaine screening in young stroke patients; leaves open causal confirmation and mechanistic validation in prospective studies.
Kozel et al. (2025) conducted a cohort in Acute ischemic stroke with cocaine use (n=74). Cocaine use was evaluated on Stroke etiology by TOAST criteria (large artery atherosclerosis). In a cohort of 74 patients with cocaine-related acute ischemic stroke, 39.2% of strokes were attributed to large-artery atherosclerosis, suggesting a higher association than previously understood.
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