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Snorting the brain away: cerebral damage as an extension of cocaine-induced midline destructive lesions

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dc.contributor.authorGarcía Pérez, Daniel
dc.contributor.authorRuiz Ortiz, Mariano
dc.contributor.authorPanero, Irene
dc.contributor.authorEiriz Fernández, Carla
dc.contributor.authorMoreno, Luis Miguel
dc.contributor.authorGarcía Reyne, Ana
dc.contributor.authorGarcía, Alfredo
dc.contributor.authorMartín Medina, Patricia
dc.contributor.authorSalvador Álvarez, Elena
dc.contributor.authorHernández Lain, Aurelio
dc.contributor.authorSerrano, Antonio
dc.contributor.authorGil Etayo, Francisco Javier
dc.contributor.authorCastaño León, Ana María
dc.contributor.authorParedes, Igor
dc.contributor.authorPérez Núñez, Ángel
dc.contributor.departmentFarmacología
dc.date.accessioned2026-02-26T12:11:33Z
dc.date.available2026-02-26T12:11:33Z
dc.date.copyright© 2020 American Association of Neuropathologists, Inc.
dc.date.issued2020-11-26
dc.description.abstractCocaine consumption is associated with a variety of clinical manifestations. Though cocaine intranasal inhalation always determines nasal mucosal damages, extensive septum perforations, and midline destructions—known as cocaine-induced midline destructive lesions (CIMDL)—affect only a limited fraction of patients. CIMDL is viewed as a cocaine-associated autoimmune phenomenon in which the presence of atypical anti-neutrophil cytoplasmic antibody (ANCA) promotes and/or defines the disease phenotype. A 51-year-old man presented with an intracranial tumor-like lesion by its space-occupying effect. CT also revealed the destruction of the nasal septum and skull base. A diagnosis of CIMDL was made in light of the patient’s history as well as findings of the physical and endoscopic examinations, imaging studies, and laboratory testing. There was no evidence of other pathologies. Histopathological results from cerebral biopsy led us to consider the intracranial pathology as an extension of the CIMDL. CIMDL is the result of a necrotizing inflammatory tissue response triggered by cocaine abuse in a subset of predisposed patients. The reported case is the first CIMDL consistent with brain extension mimicking a tumor-like lesion. While the presence of atypical ANCA seems to promote and/or define the disease phenotype, the specific role of these and other circulating autoantibodies needs further investigation.
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dc.identifier.citationJournal of Neuropathology & Experimental Neurology, Volume 79, Issue 12, December 2020, Pages 1365–1369
dc.identifier.doihttps://doi.org/10.1093/jnen/nlaa097
dc.identifier.eissn1554-6578
dc.identifier.issn0022-3069
dc.identifier.urihttp://hdl.handle.net/10201/214562
dc.languageeng
dc.publisherOxford University Press
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://academic.oup.com/jnen/article-abstract/79/12/1365/5955527
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleSnorting the brain away: cerebral damage as an extension of cocaine-induced midline destructive lesions
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
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relation.isAuthorOfPublication.latestForDiscovery2f2500a1-1b27-4420-820c-db8c16e79afd
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