Abstract WP80: Cocaine Use and Aneurysmal Subarachnoid Hemorrhage
INTRODUCTION: There have been many reports of aneurysmal subarachnoid hemorrhage (aSAH) associated with cocaine, but few studies that actually address cocaine’s influence on aSAH.  Hypertension is an accepted contributor to aneurysm rupture and has been associated with the prevalence of rupture in a younger, cocaine-using, population. [1-3] A literature search revealed only one study that correlated aneurysm size at rupture and cocaine use.  This study will retrospectively evaluate the relationship between cocaine use and aneurysm size at rupture in our aSAH patient population.
METHODS: All aSAH patients from September of 2009 through May of 2011 were reviewed at our hospital for 22 parameters that included sex, age, race, cocaine use, aneurysm size, carotid stenosis, diabetes mellitus, heart failure, hypertension, previous stroke, sickle cell disease, smoker, etc. To date only average aneurysm size was compared between the the cocaine and non-cocaine-using population using measurements from angiography reports.
In this period, 91 aSAH patients were seen at our hospital with seven positive screens for cocaine. Average aneurysm size for cocaine users was 3.7mm and 6.2mm for non-cocaine users. This was statistically significant.
CONCLUSION: Our cocaine-using patient population had an average aneurysm size much smaller than the non-cocaine-using patients. For the future, a retrospective meta-analysis using our covariates will be conducted to determine whether cocaine presents an independent risk factor for aSAH.
1. Oyesiku, N.M., et al., Cocaine-induced aneurysmal rupture: an emergent negative factor in the natural history of intracranial aneurysms? Neurosurgery, 1993. 32(4): p. 518-25; discussion 525-6.
2. Nanda, A., et al., Intracranial aneurysms and cocaine abuse: analysis of prognostic indicators. Neurosurgery, 2000. 46(5): p. 1063-7; discussion 1067-9.
3. Howington, J.U., et al., Cocaine use as a predictor of outcome in aneurysmal subarachnoid hemorrhage. J Neurosurg, 2003. 99(2): p. 271-5.
- © 2012 by American Heart Association, Inc.