To date there is only one single-center study that has exclusively reported characteristics, location, and outcomes of spontaneous intracerebral hemorrhages (ICH) among cocaine users. We aimed to describe the radiological location and characteristics along with clinical outcomes of spontaneous ICH in a similar population. We conducted a retrospective chart review of consecutive patients admitted to a tertiary care hospital, with a spontaneous ICH, who had a urine drug screen performed within 48 hours of admission. Exposure to cocaine was defined by a positive urine drug screen within 48 hours of hospital admission. Demographics, radiographic features of ICH, and short-term clinical outcomes of patients with a positive urine drug screen were analyzed and compared with the cocaine negative group. Among the 102 patients analyzed, 20 (19.6%) had documented exposure to cocaine. There was a predominance of males in both groups with significantly more Blacks in the cocaine positive group ( ). A statistically significant number of patients with cocaine use had ICH in a subcortical location ( ) when compared to cocaine negative patients. There was no difference in GCS, ICH volume, intraventricular extension, ICU days, hospital days, hospital cost, mortality, and ICH score. ICH in cocaine use is more frequently seen in the subcortical location. 1. Introduction Cocaine use leads to multiple neurovascular complications [1]. Although stroke has been a well-recognized complication of cocaine use, there have been relatively few studies evaluating the radiological and clinical characteristics of spontaneous intracerebral hemorrhages (ICH) among cocaine users [2–12]. Until recently, most of the published studies have been autopsy series and suggested vasculitis and aneurysmal rupture as common causes of ICH [13–19]. Among various types of intracranial hemorrhages in cocaine users, perhaps the most extensively described entity has been subarachnoid hemorrhage. Giraldo et al. while evaluating ischemic and hemorrhagic strokes in African American population with crack-cocaine use showed that although ICH was more common among crack-cocaine users, they had higher odds of better functional outcomes [11]. Recently Martin-Schild et al. described a cohort of patients with ICH and found that cocaine users had higher admission blood pressure, more subcortical hemorrhages, higher mortality, and worse functional outcomes compared to nonusers [20]. Most of the studies have associated spikes in blood pressure (BP) as an important etiological factor in the development of ICH. Since the
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