Man, 45, spends two months in hospital after cocaine left him brain damaged and comatose
A man who went to hospital confused and suffering with a fever was diagnosed with brain damage caused by his cocaine habit.
The 45-year-old was taken to A&E by his parents in Malta and he rapidly became more ill until falling into a coma.
Scans revealed he had suffered permanent changes to the white matter in his brain, which is made up of nerves that control learning.
Images from MRIs done regularly during his recovery show parts of the brain glowing bright white, indicating that nerve cells in the white matter have died.
And tests performed when the man came round from his coma showed he had a level of brain damage consistent with a condition closely linked to dementia.
MRI scans released by the man’s doctors in Malta show the progression of his brain damage. The scans were taken, clockwise from top left, when he was admitted and then after five days, two weeks, one month, three months and 10 months. The bright white shapes on the scans indicate that sections of the brain’s white matter have died – the brighter the white parts are, the more damaged the brain is
The unidentified patient, who went to the Mater Dei Hospital in Msida, Malta, was diagnosed with a condition called cocaine-induced leukoencephalopathy.
Leukoencephalopathy describes a progressive damaging of the brain which, in this man’s case, was caused by his taking so much cocaine.
Concerned the man may have an infection in his brain, doctors gave him antibiotics and antiviral drugs but he continued to get more unwell.
He could remember hitting his head twice within the past two weeks and his parents said it had only been two days since he last took cocaine.
His confusion was so bad the doctors, led by Dr Ylenia Abdilla, wrote in their case report: ‘The patient was not cooperative, unable to perform simple tasks and was not following commands.’
The man’s condition then got worse and worse until he ended up in a coma and his muscles stiffened up, they said in the British Medical Journal Case Reports.
HOW DOES COCAINE DAMAGE THE BRAIN?
Cocaine has been found to have a number of physical effects on the body which can cause temporary or permanent brain damage.
When the drug gets into the blood vessels it causes blood pressure to rise, heart rate to increase and is toxic to the cells in the linings of the veins and arteries.
This damage to the vessels which carry oxygen has knock-on effects on the brain because its vital blood supply can be reduced by the damage, essentially starving it of nutrients.
Regular cocaine users have also been found to have fewer sugars being used in their brain, suggesting that cells in the organ are not using as much energy because of weakness or have died completely.
Another study found cocaine increases the rate at which a person’s brain ages.
Scientists at the University of Cambridge found that while average people naturally 1.69ml of grey matter each year as they age, past or present cocaine users lose almost double this amount – 3.08ml per year.
Source: American Addiction Centers
Doctors found he had a bacterial infection in a cut above his eye and put him into intensive care where MRI scans revealed his brain damage was getting worse.
Toxic leukoencephalopathy is a condition in which there is injury to the white matter in the brain which gets progressively worse – it is often fatal.
White matter is made of nerve cells deep inside the brain, surrounded by an outer layer of grey matter.
It plays a role in controlling learning, problem-solving, walking and balancing, and someone’s mood.
It took the man a month to regain consciousness well enough to be able to watch an examiner walk around the room.
And after he was discharged after two months in hospital, a test of his thinking skills revealed he had a moderate cognitive impairment.
Mild cognitive impairment is a condition which is known to vastly increase someone’s chances of developing dementia, and he was more brain damaged than that.
After a year, however, his thinking ability had returned to normal levels, although scans still showed signs of physical damage to his brain.
Despite this he was able to live fully independently and hadn’t taken any cocaine since the devastating episode.
Dr Abdilla’s team added: ‘Prognosis [for cocaine-induced leukoencephalopathy] is poor – the condition progresses rapidly and often leads to death.
‘Rarely it has been reported to result in complete recovery, as in our case.’