{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:48:10Z","timestamp":1778028490891,"version":"3.51.4"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T00:00:00Z","timestamp":1606348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Cocaine consumption is associated with a variety of clinical manifestations. Though cocaine intranasal inhalation always determines nasal mucosal damages, extensive septum perforations, and midline destructions\u2014known as cocaine-induced midline destructive lesions (CIMDL)\u2014affect 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\u2019s 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.<\/jats:p>","DOI":"10.1093\/jnen\/nlaa097","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T10:31:09Z","timestamp":1604485869000},"page":"1365-1369","source":"Crossref","is-referenced-by-count":12,"title":["Snorting the Brain Away: Cerebral Damage as an Extension of Cocaine-Induced Midline Destructive Lesions"],"prefix":"10.1093","volume":"79","author":[{"given":"Daniel","family":"Garc\u00eda-P\u00e9rez","sequence":"first","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano","family":"Ruiz-Ortiz","sequence":"additional","affiliation":[{"name":"Department of Neurology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Panero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Eiriz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Miguel","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Garc\u00eda-Reyne","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Mart\u00edn-Medina","sequence":"additional","affiliation":[{"name":"Department of Radiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Salvador-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Radiology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelio","family":"Hern\u00e1ndez-Lain","sequence":"additional","affiliation":[{"name":"Department of Pathology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Serrano","sequence":"additional","affiliation":[{"name":"Department of Immunology, University Hospital 12 de Octubre , Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Javier","family":"Gil-Etayo","sequence":"additional","affiliation":[{"name":"Department of Immunology, University Hospital 12 de Octubre , Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Mar\u00eda","family":"Casta\u00f1o-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Paredes","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"P\u00e9rez-N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,26]]},"reference":[{"key":"2024032523362674900_nlaa097-B1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0049-0172(95)80029-8","article-title":"Cocaine-associated cerebral vasculitis","volume":"25","author":"Merkel","year":"1995","journal-title":"Semin Arthritis Rheum"},{"key":"2024032523362674900_nlaa097-B2","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/j.1552-6569.2008.00344.x","article-title":"Clinical and MRI characteristics of levamisole-induced leukoencephalopathy in 16 patients","volume":"19","author":"Xu","year":"2009","journal-title":"J Neuroimage"},{"key":"2024032523362674900_nlaa097-B3","doi-asserted-by":"crossref","first-page":"e0036","DOI":"10.5041\/RMMJ.10263","article-title":"Cocaine-induced vasculitis","volume":"7","author":"Berman","year":"2016","journal-title":"Rambam Maimonides Med J"},{"key":"2024032523362674900_nlaa097-B4","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00005792-200111000-00005","article-title":"Cocaine-induced midline destructive lesions: Clinical, radiographic, histopathologic, and serologic features and their differentiation from Wegener granulomatosis","volume":"80","author":"Trimarchi","year":"2001","journal-title":"Medicine"},{"key":"2024032523362674900_nlaa097-B5","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1056\/NEJMicm1503043","article-title":"Midline destructive lesions in a cocaine user","volume":"374","author":"Stelten","year":"2016","journal-title":"N Engl J Med"},{"key":"2024032523362674900_nlaa097-B6","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s12663-018-01182-w","article-title":"Fungal rhinosinusitis: Unravelling the disease spectrum","volume":"18","author":"Singh","year":"2019","journal-title":"J Maxillofac Oral Surg"},{"key":"2024032523362674900_nlaa097-B7","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3892\/etm.2013.1077","article-title":"Clinical features and magnetic resonance image analysis of 15 cases of demyelinating leukoencephalopathy induced by levamisole","volume":"6","author":"Yan","year":"2013","journal-title":"Exp Ther Med"},{"key":"2024032523362674900_nlaa097-B8","doi-asserted-by":"crossref","first-page":"2954","DOI":"10.1002\/art.20479","article-title":"Antineutrophil cytoplasmic antibodies reacting with human neutrophil elastase as a diagnostic marker for cocaine-induced midline destructive lesions but not autoimmune vasculitis","volume":"50","author":"Wiesner","year":"2004","journal-title":"Arthritis Rheum"},{"key":"2024032523362674900_nlaa097-B9","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1002\/art.23469","article-title":"Functional characterization of antineutrophil cytoplasmic antibodies in patients with cocaine-induced midline destructive lesions","volume":"58","author":"Peikert","year":"2008","journal-title":"Arthritis Rheum"},{"key":"2024032523362674900_nlaa097-B10","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s13000-015-0279-z","article-title":"Pathologic manifestations of levamisole-adulterated cocaine exposure","volume":"10","author":"Nolan","year":"2015","journal-title":"Diagn Pathol"},{"key":"2024032523362674900_nlaa097-B11","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1136\/jnnp.2004.047134","article-title":"Fatal toxic leukoencephalopathy: Clinical, radiological, and necropsy findings in two patients","volume":"76","author":"Ryan","year":"2005","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2024032523362674900_nlaa097-B12","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/00002281-199901000-00005","article-title":"The role of superantigens in vasculitis","volume":"11","author":"Tervaert","year":"1999","journal-title":"Curr Opin Rheumatol"},{"key":"2024032523362674900_nlaa097-B13","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1001\/jama.2013.6285","article-title":"Seroconversion to multiple islet autoantibodies and risk of progression to diabetes in children","volume":"309","author":"Ziegler","year":"2013","journal-title":"JAMA"},{"key":"2024032523362674900_nlaa097-B14","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1038\/ncpneuro0918","article-title":"BOLD-MRI cerebrovascular reactivity findings in cocaine-induced cerebral vasculitis","volume":"4","author":"Han","year":"2008","journal-title":"Nat Rev Neurol"},{"key":"2024032523362674900_nlaa097-B15","first-page":"37","article-title":"Evaluation and treatment of central nervous system vasculitis","volume":"7","author":"Calabrese","year":"1995","journal-title":"Curr Opin Rheumatol"}],"container-title":["Journal of Neuropathology &amp; Experimental Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jnen\/article-pdf\/79\/12\/1365\/34692988\/nlaa097.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jnen\/article-pdf\/79\/12\/1365\/34692988\/nlaa097.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T23:55:59Z","timestamp":1711410959000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnen\/article\/79\/12\/1365\/5955527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,26]]},"references-count":15,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,11,26]]},"published-print":{"date-parts":[[2020,12,4]]}},"URL":"https:\/\/doi.org\/10.1093\/jnen\/nlaa097","relation":{},"ISSN":["0022-3069","1554-6578"],"issn-type":[{"value":"0022-3069","type":"print"},{"value":"1554-6578","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,11,26]]}}}