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BOLD-MRI cerebrovascular reactivity findings in cocaine-induced cerebral vasculitis

Nature Clinical Practice Neurology volume 4, pages 628–632 (2008)Cite this article

Abstract

Background An 18-year-old woman presented to a regional stroke center with dysphasia and right hemiparesis 2 days after consuming alcohol and inhaling cannabis and—for the first time—cocaine.

Investigations Physical examination, blood tests for inflammatory markers, vasculitis and toxicology screen, echocardiography, electrocardiography, CT scanning, brain MRI, magnetic resonance angiography, magnetic resonance vessel wall imaging, catheter angiography, and correlation of blood oxygen level-dependent (BOLD)-MRI signal intensity with changes in end-tidal partial pressure of carbon dioxide.

Diagnosis Cocaine-induced cerebral vasculitis.

Management No specific therapy was initiated. The patient's vital signs and neurological status were monitored during her admission. Follow-up medical imaging was performed after the patient's discharge from hospital.

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Figure 1: Results from brain imaging studies performed at initial presentation of a patient with cocaine-induced cerebral vasculitis.
Figure 2: Whole-brain BOLD-MRI cerebrovascular reactivity maps obtained after admission of a patient with cocaine-induced cerebral vasculitis.
Figure 3: Follow-up MRI findings 1 month after discharge of a patient with cocaine-induced cerebral vasculitis.

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Authors and Affiliations

  1. JS Han is an MSc candidate in the Department of Physiology at the University of Toronto and the Department of Anesthesia at the University Health Network, and DM Mandell is a Resident in the Department of Medical Imaging at the University Health Network, Toronto, ON, Canada.,

    Jay S Han & Daniel M Mandell

  2. A Mardimae is a graduate, M Slessarev is a medical student, C Jaigobin is a Stroke Neurologist and Assistant Professor of Medicine, and JA Fisher is an Anesthesiologist and Professor, all at the University of Toronto, Toronto, ON, Canada.,

    Alexandra Mardimae, Marat Slessarev, Cheryl Jaigobin & Joseph A Fisher

  3. DJ Mikulis is Full Professor and Co-Director of Medicine Imaging Research in the Department of Medical Imaging at the University Health Network and the University of Toronto, Toronto, ON, Canada.,

    David J Mikulis

  4. J Poublanc is a graduate of the University of Toulouse, Toulouse, France.,

    Julien Poublanc

Authors
  1. Jay S Han
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  2. Daniel M Mandell
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  3. Julien Poublanc
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  4. Alexandra Mardimae
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  5. Marat Slessarev
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  7. Joseph A Fisher
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  8. David J Mikulis
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Corresponding author

Correspondence to David J Mikulis.

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Competing interests

JA Fisher, M Slessarev and DJ Mikulis are patent holders/applicants with Thornhill Research, with which JA Fisher and DJ Mikulis are also stock-holders/directors. The other authors declared no competing interests.

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Han, J., Mandell, D., Poublanc, J. et al. BOLD-MRI cerebrovascular reactivity findings in cocaine-induced cerebral vasculitis. Nat Rev Neurol 4, 628–632 (2008). https://doi.org/10.1038/ncpneuro0918

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