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Consumo de drogas ilícitas e AVC
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Estima-se que actualmente, 5,6% da população mundial já tenha consumido alguma droga ilícita, com os dados a apontarem para números cada vez maiores e mais relevantes principalmente nos adultos jovens. O mecanismo de acção das várias substâncias de consumo já foi associado ao acidente vascular cerebral (AVC) pelas alterações provocadas, por exemplo, na autorregulação cerebral, na pressão arterial, no ritmo cardíaco, na vasculatura e na hemostase, o que faz com que estas sejam um factor de risco a ter em conta numa síndrome clínica que acarreta elevada morbilidade e mortalidade. Desta forma, o presente estudo retrospectivo procura caracterizar melhor o perfil do consumidor de drogas ilícitas que é vítima de AVC e estabelecer eventuais nexos de causalidade que permitam uma melhor compreensão do doente. Para tal procedeu-se à caracterização do consumo de cada doente assim como do respectivo AVC, confrontando os dados obtidos com controlos sem hábitos toxicofílicos. Destacam-se indivíduos mais jovens e prevalência do sexo masculino junto dos doentes consumidores, que também apresentam maior incidência de tabagismo, alcoolismo e hepatites virais. Neste grupo há uma percentagem relevante de AVCs criptogénicos e uma possível tendência para hemorragia subaracnoideia e para AVCs isquémicos com o consumo de canábis. Não se identificaram variações significativas em termos de prognóstico nos dois grupos. Conclui-se por fim que as drogas ilícitas são um factor de risco indiscutível para a ocorrência de AVCs, e que os doentes que as consomem possuem certas nuances em termos epidemiológicos, de factores de risco e provavelmente de tipos de AVC que devem ser tidas em conta para uma melhor abordagem clínica dos mesmos.
It is estimated that at present, 5.6% of the world's population has already consumed some illicit drug, with data pointing to increasing numbers mainly in young adults. The mechanism of action of the various substances of consumption has already been associated with stroke due to changes in, for example, brain self-regulation, blood pressure, heart rate, vasculature and hemostasis, making them a risk factor to be considered in a clinical syndrome that causes high morbidity and mortality. Thus, the present retrospective study seeks to better characterize the profile of illicit drug users who are victims of stroke and to establish possible causality links that allow a better understanding of the patient. For this purpose, the consumption of each patient as well as the respective stroke was characterized, comparing the data obtained with controls without these habits. We highlight the younger age and male prevalence among consuming patients, who also have a higher incidence of smoking, alcoholism and viral hepatitis. In this group there is a relevant percentage of cryptogenic strokes and a possible tendency for subarachnoid hemorrhage and for ischemic strokes with cannabis use. There were no significant changes in prognosis in the two groups. Finally, we conclude that illicit drugs are an indisputable risk factor for the occurrence of stroke, and that patients who consume them have certain nuances in terms of epidemiology, risk factors and probably types of strokes that should be considered for a better clinical approach.
It is estimated that at present, 5.6% of the world's population has already consumed some illicit drug, with data pointing to increasing numbers mainly in young adults. The mechanism of action of the various substances of consumption has already been associated with stroke due to changes in, for example, brain self-regulation, blood pressure, heart rate, vasculature and hemostasis, making them a risk factor to be considered in a clinical syndrome that causes high morbidity and mortality. Thus, the present retrospective study seeks to better characterize the profile of illicit drug users who are victims of stroke and to establish possible causality links that allow a better understanding of the patient. For this purpose, the consumption of each patient as well as the respective stroke was characterized, comparing the data obtained with controls without these habits. We highlight the younger age and male prevalence among consuming patients, who also have a higher incidence of smoking, alcoholism and viral hepatitis. In this group there is a relevant percentage of cryptogenic strokes and a possible tendency for subarachnoid hemorrhage and for ischemic strokes with cannabis use. There were no significant changes in prognosis in the two groups. Finally, we conclude that illicit drugs are an indisputable risk factor for the occurrence of stroke, and that patients who consume them have certain nuances in terms of epidemiology, risk factors and probably types of strokes that should be considered for a better clinical approach.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Palavras-chave
Acidente vascular cerebral Drogas ilícitas Jovens adultos Neurologia