Lipton R B, Choy-Kwong M, Solomon S
Headache. 1989 Apr;29(4):225-8. doi: 10.1111/j.1526-4610.1989.hed22904225.x.
We reviewed the medical records of 283 cocaine users consecutively admitted to a municipal hospital and identified 37 patients (13.1%) complaining of headaches. These patients were divided into three groups. Three patients had migraine-like headaches and transient hemiparesis associated with cocaine use. Five patients had headaches associated with cocaine withdrawal. In 29 patients headaches were not clearly associated with cocaine. Twenty-two of the 29 had chronic daily headaches; nine of these patients were depressed. Three had focal brain lesions with chronic daily headache or acute onset global headache. The four remaining patients had other headaches. Based on these findings, we conclude that: (1) Headache is a common complaint in hospitalized cocaine users; (2) Cocaine may occasionally trigger a syndrome which resembles hemiplegic migraine. The potential mechanisms of this syndrome will be discussed; (3) Hospitalized cocaine users who present with headaches most frequently have depression with suicidal ideation, often associated with cocaine withdrawal; and (4) Structural brain disease in these patients may result from a variety of causes.
我们回顾了连续入住一家市立医院的283名可卡因使用者的病历，确定了37名（13.1%）主诉头痛的患者。这些患者被分为三组。三名患者出现类似偏头痛的头痛并伴有与使用可卡因相关的短暂性偏瘫。五名患者的头痛与可卡因戒断有关。在29名患者中，头痛与可卡因没有明显关联。这29名患者中有22名患有慢性每日头痛；其中9名患者有抑郁症状。三名患者有局灶性脑病变，伴有慢性每日头痛或急性发作的全头痛。其余四名患者有其他类型的头痛。基于这些发现，我们得出以下结论：（1）头痛是住院可卡因使用者的常见主诉；（2）可卡因偶尔可能引发一种类似偏瘫性偏头痛的综合征。将讨论该综合征的潜在机制；（3）出现头痛的住院可卡因使用者最常伴有抑郁并有自杀意念，且常与可卡因戒断有关；（4）这些患者的脑部结构疾病可能由多种原因引起。
