Open AccessFatal encephalopathy after an isolated overdose of cocaine
Author(s) -
Daniel Kondziella,
E. Michael Danielsen,
P. Arlien-Soeborg
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.06.2009.2003
Subject(s) - medicine , toxic encephalopathy , coma (optics) , encephalopathy , cerebral hypoxia , anesthesia , autopsy , dementia , cerebral vasculitis , personality changes , brain damage , vasospasm , hypoxia (environmental) , hyperventilation , cerebral blood flow , white matter , neurology , vasculitis , pathology , disease , subarachnoid hemorrhage , ischemia , psychiatry , magnetic resonance imaging , chemistry , physics , organic chemistry , oxygen , optics , radiology
Cocaine induced brain damage can be divided into primary neurotoxic effects causing toxic encephalopathy, secondary effects of compromised cerebral blood flow in ischaemic and haemorrhagic stroke, cerebral vasculitis and vasospasm, and tertiary effects due to hypoxia as a result of cardiopulmonary collapse. Toxic leucoencephalopathy mainly affects white matter (WM) tracts serving higher cerebral function, thereby leading to altered personality, attention deficits and memory impairment in mild cases and to dementia, coma and brain death in severe cases. Here we describe the case of a 21-year-old man who committed suicide by injecting cocaine. The cocaine induced a toxic leucoencephalopathy, which was proven at autopsy.