In a review of the records of 3,712 drug abusers, 13 patients were identified 
with neurologic deficits attributable to the use of cocaine. Ischemic 
manifestations were the most frequent, occurring in seven (54%) patients, with a 
mean age of 34.2 years. Three (23%) patients had subarachnoid hemorrhage, and 
three (23%) had intracerebral hemorrhage. Three patients from other institutions 
were included in the analysis, for a total of 16 patients, (eight with cerebral 
ischemia, four with subarachnoid hemorrhage, and four with intracerebral 
hemorrhage). Of the six patients with head computed tomographic findings of 
cerebral infarction, five had subcortical infarcts. Two of the four patients who 
presented with a subarachnoid hemorrhage had a congenital intracranial aneurysm. 
One of the four patients with an intracerebral hemorrhage had an underlying 
arteriovenous malformation. The mechanism through which these complications 
occur is not completely understood. Factors that may play a role include the 
acute hypertensive response that occurs with cocaine use as well as disordered 
neurovascular control.