Subarachnoid and intracerebral hemorrhage in cocaine abusers

Background/Aim. Cocaine is an alkaloid extracted from the leaves of the plants Erythroxylum coca and Erythroxylum novogranatense. It can be taken orally, intranasally, intravenously, by inhalation, or intragenitally. Cocaine abuse can cause subarachnoid and intracerebral hemorrhage. The aim of this...

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Main Authors: Aleksić Ivan, Džambas Jelena, Marinković Nadica, Šegrt Zoran, Nikolić Marina
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000034A.pdf
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author Aleksić Ivan
Džambas Jelena
Marinković Nadica
Šegrt Zoran
Nikolić Marina
author_facet Aleksić Ivan
Džambas Jelena
Marinković Nadica
Šegrt Zoran
Nikolić Marina
author_sort Aleksić Ivan
collection DOAJ
description Background/Aim. Cocaine is an alkaloid extracted from the leaves of the plants Erythroxylum coca and Erythroxylum novogranatense. It can be taken orally, intranasally, intravenously, by inhalation, or intragenitally. Cocaine abuse can cause subarachnoid and intracerebral hemorrhage. The aim of this study was to determine cocaine and benzoylecgonine (BZ) concentrations in various body fluids and organs, the frequency of subarachnoid and intracerebral hemorrhage, and the relationship of concentration of cocaine and BZ in different body fluids with subarachnoid and intracerebral hemorrhage. Methods. The study analyzed a total of 26 autopsies reports from 2005 to 2018 with detected cocaine and/or BZ in the bodies during a forensic autopsy at the Institute of Pathology and Forensic Medicine, Military Medical Academy in Belgrade, Serbia. Brain tissue was taken for histopathological analysis and blood from the femoral vein, while urine, gastric content, brain, kidney, and liver with gallbladder samples were taken for toxicological analyses. Results. There were 26 autopsied patients aged 23 to 56 years (mean age 33.77±8.52); 20 (75.92%) were men and 6 (23.08%) were women. Cocaine was found in the blood of 12 (46.15%), in the urine of 15 (57.69%), and in the brain of 8 (30.77%) autopsied patients. BZ was found in the blood of 20 (76.92%), in the urine of 21 (80.77%), and in the brain of 10 (38.46%) autopsied patients. Subarachnoid hemorrhage was found in 10 (38.46%), intracerebral hemorrhage in 18 (69.23%), and both subarachnoid and intracerebral hemorrhage in 6 (23.07%) autopsied patients. Intracerebral (focal and perivascular) hemorrhage was more frequent. There were statistically significantly higher concentrations of both cocaine and BZ in most of the body fluids and organs of examinees with intracranial hemorrhage compared to examinees without hemorrhage. Conclusion. Subarachnoid and intracerebral hemorrhage were frequent findings in autopsied cocaine abusers. The correlation between subarachnoid and intracerebral hemorrhage and cocaine concentrations in blood was moderate. There were strong correlation between subarachnoid and intracerebral hemorrhage and BZ concentrations in almost all the samples.
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spelling doaj-art-13e519bd7dcf47f791e4c47d9f95240f2025-08-20T02:04:51ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178111166117210.2298/VSP191229034A0042-84502000034ASubarachnoid and intracerebral hemorrhage in cocaine abusersAleksić Ivan0Džambas Jelena1Marinković Nadica2Šegrt Zoran3Nikolić Marina4https://orcid.org/0000-0002-7223-424XMilitary Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Ministry of Defence of the Republic of Serbia, Military Health Department, Belgrade, SerbiaSerbian Army, Fourth Army Brigade, 41st Infantry Battalion, Department of Health Protection, Vranje, SerbiaBackground/Aim. Cocaine is an alkaloid extracted from the leaves of the plants Erythroxylum coca and Erythroxylum novogranatense. It can be taken orally, intranasally, intravenously, by inhalation, or intragenitally. Cocaine abuse can cause subarachnoid and intracerebral hemorrhage. The aim of this study was to determine cocaine and benzoylecgonine (BZ) concentrations in various body fluids and organs, the frequency of subarachnoid and intracerebral hemorrhage, and the relationship of concentration of cocaine and BZ in different body fluids with subarachnoid and intracerebral hemorrhage. Methods. The study analyzed a total of 26 autopsies reports from 2005 to 2018 with detected cocaine and/or BZ in the bodies during a forensic autopsy at the Institute of Pathology and Forensic Medicine, Military Medical Academy in Belgrade, Serbia. Brain tissue was taken for histopathological analysis and blood from the femoral vein, while urine, gastric content, brain, kidney, and liver with gallbladder samples were taken for toxicological analyses. Results. There were 26 autopsied patients aged 23 to 56 years (mean age 33.77±8.52); 20 (75.92%) were men and 6 (23.08%) were women. Cocaine was found in the blood of 12 (46.15%), in the urine of 15 (57.69%), and in the brain of 8 (30.77%) autopsied patients. BZ was found in the blood of 20 (76.92%), in the urine of 21 (80.77%), and in the brain of 10 (38.46%) autopsied patients. Subarachnoid hemorrhage was found in 10 (38.46%), intracerebral hemorrhage in 18 (69.23%), and both subarachnoid and intracerebral hemorrhage in 6 (23.07%) autopsied patients. Intracerebral (focal and perivascular) hemorrhage was more frequent. There were statistically significantly higher concentrations of both cocaine and BZ in most of the body fluids and organs of examinees with intracranial hemorrhage compared to examinees without hemorrhage. Conclusion. Subarachnoid and intracerebral hemorrhage were frequent findings in autopsied cocaine abusers. The correlation between subarachnoid and intracerebral hemorrhage and cocaine concentrations in blood was moderate. There were strong correlation between subarachnoid and intracerebral hemorrhage and BZ concentrations in almost all the samples.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000034A.pdfbraincocaineautopsybloodcerebral hemorrhagecocaine-related disorderssubarachnoid hemorrhage
spellingShingle Aleksić Ivan
Džambas Jelena
Marinković Nadica
Šegrt Zoran
Nikolić Marina
Subarachnoid and intracerebral hemorrhage in cocaine abusers
Vojnosanitetski Pregled
brain
cocaine
autopsy
blood
cerebral hemorrhage
cocaine-related disorders
subarachnoid hemorrhage
title Subarachnoid and intracerebral hemorrhage in cocaine abusers
title_full Subarachnoid and intracerebral hemorrhage in cocaine abusers
title_fullStr Subarachnoid and intracerebral hemorrhage in cocaine abusers
title_full_unstemmed Subarachnoid and intracerebral hemorrhage in cocaine abusers
title_short Subarachnoid and intracerebral hemorrhage in cocaine abusers
title_sort subarachnoid and intracerebral hemorrhage in cocaine abusers
topic brain
cocaine
autopsy
blood
cerebral hemorrhage
cocaine-related disorders
subarachnoid hemorrhage
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000034A.pdf
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AT dzambasjelena subarachnoidandintracerebralhemorrhageincocaineabusers
AT marinkovicnadica subarachnoidandintracerebralhemorrhageincocaineabusers
AT segrtzoran subarachnoidandintracerebralhemorrhageincocaineabusers
AT nikolicmarina subarachnoidandintracerebralhemorrhageincocaineabusers