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    Simultaneous multifocal intracranial haemorrhage (ICH) and subarachnoid haemorrhage (SAH) in the setting of long-term cocaine usage

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    Author
    Basi, Saajan
    Punekar, Shuja
    Keyword
    Stroke
    Toxicology
    Trauma CNS/PNS
    Vasculitis
    Date
    2021-06
    
    Metadata
    Show full item record
    DOI
    10.1136/bcr-2020-241311
    Abstract
    A 45-year-old Caucasian man was admitted to hospital following a collapse at home. On admission, this patient was noted to have a Glasgow Coma Scale (GCS) Score of 9 out of 15, fever and tachypnoea. The patient was identified to have bilateral limb weakness, predominately on the left side, with associated dysphagia. Radiological imaging demonstrated bilateral multifocal intracranial haemorrhage and subarachnoid haemorrhage. Neurosurgical input was sought; the outcome of this was a decision to manage the patient conservatively, without surgical intervention. Of note, his urine drug testing revealed a positive result for a cocktail of drugs including cocaine, benzoylecgonine (cocaine metabolite), methadone, heroin, norbuprenorphine and benzodiazepine. Throughout the admission, the patient was monitored in an intensive care setting. The patient received support with feeding, speech and mobilisation. The patients' GCS improved throughout the admission. Following a 30-day admission, the patient walked home.
    Citation
    BMJ Case Rep. 2021 Jun 17;14(6):e241311
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/14942
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