TY - JOUR
TI - A Mechanistic and pathophysiological approach for stroke associated with drugs of abuse
AU - Tsatsakis, A.
AU - Docea, A.O.
AU - Calina, D.
AU - Tsarouhas, K.
AU - Zamfira, L.-M.
AU - Mitrut, R.
AU - Sharifi-Rad, J.
AU - Kovatsi, L.
AU - Siokas, V.
AU - Dardiotis, E.
AU - Drakoulis, N.
AU - Lazopoulos, G.
AU - Tsitsimpikou, C.
AU - Mitsias, P.
AU - Neagu, M.
JO - Journal of Clinical Medicine Research
PY - 2019
VL - 8
TODO - 9
SP - null
PB - MDPI
SN - 1918-3003, 1918-3011
TODO - 10.3390/jcm8091295
TODO - amphetamine derivative;  anabolic agent;  cannabis;  cocaine;  diamorphine;  morphine, amphetamine dependence;  aneurysm;  bacterial arthritis;  bacterial endocarditis;  blood pressure;  brain hemorrhage;  brain ischemia;  cannabis addiction;  cardiovascular risk;  cocaine dependence;  computed tomographic angiography;  drug abuse;  drug exposure;  embolism;  erythropoiesis;  experimental stroke;  genetic variability;  heart arrhythmia;  heroin dependence;  human;  hypereosinophilia;  hypertension;  hypoxia;  middle cerebral artery occlusion;  morphine addiction;  nuclear magnetic resonance imaging;  opiate addiction;  pathophysiology;  Psilocybe;  reperfusion injury;  Review;  transient ischemic attack;  vasculitis;  vasospasm
TODO - Drugs of abuse are associated with stroke, especially in young individuals. The major classes of drugs linked to stroke are cocaine, amphetamines, heroin, morphine, cannabis, and new synthetic cannabinoids, along with androgenic anabolic steroids (AASs). Both ischemic and hemorrhagic stroke have been reported due to drug abuse. Several common mechanisms have been identified, such as arrhythmias and cardioembolism, hypoxia, vascular toxicity, vascular spasm and effects on the thrombotic mechanism, as causes for ischemic stroke. For hemorrhagic stroke, acute hypertension, aneurysm formation/rupture and angiitis-like changes have been implicated. In AAS abuse, the effect of blood pressure is rather substance specific, whereas increased erythropoiesis usually leads to thromboembolism. Transient vasospasm, caused by synthetic cannabinoids, could lead to ischemic stroke. Opiates often cause infective endocarditis, resulting in ischemic stroke and hypereosinophilia accompanied by pyogenic arthritis, provokinghemorrhagic stroke. Genetic variants are linked to increased risk for stroke in cocaine abuse. The fact that case reports on cannabis-induced stroke usually refer to the young population is very alarming. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
ER -