Krendel D A, Ditter S M, Frankel M R, Ross W K
Department of Neurology, Emory University School of Medicine, Atlanta, GA.
Neurology. 1990 Jul;40(7):1092-4. doi: 10.1212/wnl.40.7.1092.
We report cerebral vasculitis in 2 cocaine users who developed symptoms (transient blindness and persistent headache) while smoking "crack," followed by progressive widespread cerebral dysfunction with focal signs over the next few weeks. One patient had smoked crack exclusively, and the other also used cocaine intravenously. Sedimentation rates were elevated and HIV titers negative. Arteriography was normal in 1 patient and in the other showed multiple large-vessel occlusions without beading. Brain biopsy showed vasculitis involving small vessels in both patients. Multinucleated cells were present in the neuropil, but there were no granulomas or evidence of infection. One patient improved significantly with corticosteroid treatment, and made a good recovery. The other died despite corticosteroid and cyclophosphamide treatment.
我们报告了2名可卡因使用者发生的脑血管炎。这2名患者在吸食“快克”可卡因时出现症状（短暂失明和持续性头痛），随后在接下来的几周内逐渐出现广泛的脑功能障碍并伴有局灶性体征。其中1名患者仅吸食过快克，另1名患者还静脉使用过可卡因。血沉升高，HIV滴度为阴性。1名患者的血管造影正常，另1名患者的血管造影显示多条大血管闭塞但无串珠样改变。脑活检显示两名患者均有累及小血管的血管炎。神经纤维网中有多核细胞，但无肉芽肿或感染证据。1名患者经皮质类固醇治疗后明显好转，恢复良好。另1名患者尽管接受了皮质类固醇和环磷酰胺治疗仍死亡。
