{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:29:20Z","timestamp":1791041360984,"version":"4.1.0"},"reference-count":174,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Research and Innovation in Romania","award":["PN-III-P1-1.2-PCCDI-2017-0341\/2018, PN 19.29.01.01"],"award-info":[{"award-number":["PN-III-P1-1.2-PCCDI-2017-0341\/2018, PN 19.29.01.01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Drugs of abuse are associated with stroke, especially in young individuals. The major classes of drugs linked to stroke are cocaine, amphetamines, heroin, morphine, cannabis, and new synthetic cannabinoids, along with androgenic anabolic steroids (AASs). Both ischemic and hemorrhagic stroke have been reported due to drug abuse. Several common mechanisms have been identified, such as arrhythmias and cardioembolism, hypoxia, vascular toxicity, vascular spasm and effects on the thrombotic mechanism, as causes for ischemic stroke. For hemorrhagic stroke, acute hypertension, aneurysm formation\/rupture and angiitis-like changes have been implicated. In AAS abuse, the effect of blood pressure is rather substance specific, whereas increased erythropoiesis usually leads to thromboembolism. Transient vasospasm, caused by synthetic cannabinoids, could lead to ischemic stroke. Opiates often cause infective endocarditis, resulting in ischemic stroke and hypereosinophilia accompanied by pyogenic arthritis, provoking hemorrhagic stroke. Genetic variants are linked to increased risk for stroke in cocaine abuse. The fact that case reports on cannabis-induced stroke usually refer to the young population is very alarming.<\/jats:p>","DOI":"10.3390\/jcm8091295","type":"journal-article","created":{"date-parts":[[2019,8,26]],"date-time":"2019-08-26T04:38:23Z","timestamp":1566794303000},"page":"1295","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":125,"title":["A Mechanistic and Pathophysiological Approach for Stroke Associated with Drugs of Abuse"],"prefix":"10.3390","volume":"8","author":[{"given":"Aristides","family":"Tsatsakis","sequence":"first","affiliation":[{"name":"Center of Toxicology Science &amp; Research, Medical School, University of Crete, 71003 Heraklion, Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Oana","family":"Docea","sequence":"additional","affiliation":[{"name":"Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1523-9116","authenticated-orcid":false,"given":"Daniela","family":"Calina","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2651-3579","authenticated-orcid":false,"given":"Konstantinos","family":"Tsarouhas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of Larissa, 41221 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura-Maria","family":"Zamfira","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radu","family":"Mitrut","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"},{"name":"Department of Cardiology, University and Emergency Hospital, 050098 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7301-8151","authenticated-orcid":false,"given":"Javad","family":"Sharifi-Rad","sequence":"additional","affiliation":[{"name":"Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol 61615-585, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leda","family":"Kovatsi","sequence":"additional","affiliation":[{"name":"Laboratory of Forensic Medicine and Toxicology, School of Medicine, Aristotle University of Thessaloniki, 54248 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasileios","family":"Siokas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke Unit, University of Thessaly, University Hospital of Larissa, 41221 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efthimios","family":"Dardiotis","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke Unit, University of Thessaly, University Hospital of Larissa, 41221 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7545-8089","authenticated-orcid":false,"given":"Nikolaos","family":"Drakoulis","sequence":"additional","affiliation":[{"name":"Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Lazopoulos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University General Hospital of Heraklion, University of Crete, Medical School, 71003 Heraklion, Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tsitsimpikou","sequence":"additional","affiliation":[{"name":"Department of Hazardous Substances, Mixtures and Articles, General Chemical State Laboratory of Greece, 10431 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis","family":"Mitsias","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of Crete, 71003 Heraklion, Greece"},{"name":"Comprehensive Stroke Center and Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Neagu","sequence":"additional","affiliation":[{"name":"Department of Immunology, Victor Babes National Institute of Pathology, 050096 Bucharest, Romania"},{"name":"Department of Pathology, Colentina Clinical Hospital, 021183 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2276","DOI":"10.1161\/STROKEAHA.108.192218","article-title":"Definition and evaluation of transient ischemic attack: A scientific statement for healthcare professionals from the American Heart Association\/American Stroke Association Stroke Council; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; and the Interdisciplinary Council on Peripheral Vascular Disease. The American Academy of Neurology affirms the value of this statement as an educational tool for neurologists","volume":"40","author":"Easton","year":"2009","journal-title":"Stroke"},{"key":"ref_2","unstructured":"National Collaborating Centre for Chronic Conditions (2008). National Collaborating Centre for Chronic Conditions. National Institute for Health and Clinical Excellence: Guidance. Stroke: National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischaemic Attack (TIA), Royal College of Physicians (UK) Royal College of Physicians of London."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Johnson, W., Onuma, O., Owolabi, M., and Sachdev, S. (2016). Stroke: A global response is needed. Bull. World Health Organ., 94.","DOI":"10.2471\/BLT.16.181636"},{"key":"ref_4","unstructured":"United Nations Oddice on Drugs and Crime (2019, February 26). World Drug Report 2017. Available online: https:\/\/www.unodc.org\/wdr2017\/field\/WDR_2017_presentation_lauch_version.pdf."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2147\/VHRM.S53203","article-title":"Strokes in young adults: Epidemiology and prevention","volume":"11","author":"Smajlovic","year":"2015","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1747-4949.2012.00969.x","article-title":"Stroke disability and rehabilitation of stroke: World Health Organization perspective","volume":"8","author":"Mendis","year":"2013","journal-title":"Int. J. Stroke"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5830\/CVJA-2013-001","article-title":"Management of ischaemic stroke in the acute setting: Review of the current status","volume":"24","author":"Jivan","year":"2013","journal-title":"Cardiovasc. J. Afr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1161\/STROKEAHA.116.015565","article-title":"Cannabis, Tobacco, Alcohol Use, and the Risk of Early Stroke: A Population-Based Cohort Study of 45,000 Swedish Men","volume":"48","author":"Falkstedt","year":"2017","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S0072-9752(08)93041-4","article-title":"Illicit drug use\/abuse and stroke","volume":"93","author":"Sloan","year":"2009","journal-title":"Handb. Clin. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4115","DOI":"10.1113\/jphysiol.2011.212886","article-title":"Ischaemic stroke: A thrombo-inflammatory disease?","volume":"589","author":"Nieswandt","year":"2011","journal-title":"J. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/s41582-019-0221-1","article-title":"Thrombo-inflammation in acute ischaemic stroke\u2014Implications for treatment","volume":"15","author":"Stoll","year":"2019","journal-title":"Nat. Rev. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1177\/1076029616631424","article-title":"Assessing Circulating Factor VIIa-Antithrombin Complexes in Acute Ischemic Stroke: A Pilot Study","volume":"23","author":"Slomka","year":"2017","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e328","DOI":"10.1111\/ene.12591","article-title":"Tissue-factor-bearing microparticles (MPs-TF) in patients with acute ischaemic stroke: The influence of stroke treatment on MPs-TF generation","volume":"22","author":"Switonska","year":"2015","journal-title":"Eur. J. Neurol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1159\/000346599","article-title":"Hematoma expansion following acute intracerebral hemorrhage","volume":"35","author":"Brouwers","year":"2013","journal-title":"Cerebrovasc. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1007\/s11936-013-0277-y","article-title":"New avenues for treatment of intracranial hemorrhage","volume":"16","author":"Sonni","year":"2014","journal-title":"Curr. Treat. Options Cardiovasc. Med."},{"key":"ref_16","first-page":"779","article-title":"Cancer-associated stroke: Pathophysiology, detection and management (Review)","volume":"54","author":"Dardiotis","year":"2019","journal-title":"Int. J. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Teodoro, M., Briguglio, G., Fenga, C., and Costa, C. (2019). Genetic polymorphisms as determinants of pesticide toxicity: Recent advances. Toxicol. Rep.","DOI":"10.1016\/j.toxrep.2019.06.004"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1111\/j.1360-0443.2008.02231.x","article-title":"Methamphetamine-related fatalities in Australia: Demographics, circumstances, toxicology and major organ pathology","volume":"103","author":"Kaye","year":"2008","journal-title":"Addiction"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"821","DOI":"10.7326\/0003-4819-113-11-821","article-title":"Emergence of recreational drug abuse as a major risk factor for stroke in young adults","volume":"113","author":"Kaku","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1007\/s12028-008-9177-5","article-title":"Cerebrovascular complications of methamphetamine abuse","volume":"10","author":"Ho","year":"2009","journal-title":"Neurocrit. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/j.1365-2990.2010.01131.x","article-title":"Review: The neuropathology of drug abuse","volume":"37","author":"Buttner","year":"2011","journal-title":"Neuropathol. Appl. Neurobiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1212\/WNL.41.9.1358","article-title":"Occurrence of stroke associated with use\/abuse of drugs","volume":"41","author":"Sloan","year":"1991","journal-title":"Neurology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s00702-007-0715-7","article-title":"Cannabis and Ecstasy\/MDMA (3,4-methylenedioxymethamphetamine): An analysis of their neuropsychobiological interactions in recreational users","volume":"114","author":"Parrott","year":"2007","journal-title":"J. Neural Transm. (Vienna, Austria: 1996)"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1177\/0269881113482532","article-title":"Amphetamine, past and present\u2014A pharmacological and clinical perspective","volume":"27","author":"Heal","year":"2013","journal-title":"J. Psychopharmacol. (Oxford, UK)"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.pnpbp.2015.04.002","article-title":"Amphetamine and other pharmacological agents in human and animal studies of recovery from stroke","volume":"64","author":"Mehta","year":"2016","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"8923","DOI":"10.1523\/JNEUROSCI.1033-13.2013","article-title":"Amphetamine mechanisms and actions at the dopamine terminal revisited","volume":"33","author":"Calipari","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0378-4274(99)00205-2","article-title":"Amphetamine designer drugs\u2014An overview and epidemiology","volume":"112\u2013113","author":"Christophersen","year":"2000","journal-title":"Toxicol. Lett."},{"key":"ref_28","first-page":"214","article-title":"Methamphetamine and the expanding complications of amphetamines","volume":"170","author":"Albertson","year":"1999","journal-title":"West. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1001\/archpsyc.64.4.495","article-title":"Stroke in young adults who abuse amphetamines or cocaine: A population-based study of hospitalized patients","volume":"64","author":"Westover","year":"2007","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"610","DOI":"10.5694\/mja11.10558","article-title":"Ischaemic stroke among young people aged 15 to 50 years in Adelaide, South Australia","volume":"195","author":"Phillips","year":"2011","journal-title":"Med. J. Aust."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/dar.12559","article-title":"Risk of stroke in prescription and other amphetamine-type stimulants use: A systematic review","volume":"37","author":"Indave","year":"2018","journal-title":"Drug Alcohol Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jemermed.2004.06.015","article-title":"Delayed ischemic stroke associated with methamphetamine use","volume":"28","author":"Ohta","year":"2005","journal-title":"J. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jstrokecerebrovasdis.2007.04.001","article-title":"Amphetamine-associated ischemic stroke: Clinical presentation and proposed pathogenesis","volume":"16","author":"Wong","year":"2007","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_34","first-page":"123","article-title":"Intracerebral and subarachnoid hemorrhage following use of methamphetamine (\u201cspeed\u201d)","volume":"53","author":"Weiss","year":"1970","journal-title":"Int. J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/0976-500X.92491","article-title":"Phenylpropanolamine and the hemorrhagic stroke: A new search for the culprit","volume":"3","author":"Yakoot","year":"2012","journal-title":"J. Pharmacol. Pharmacother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.brainres.2010.12.017","article-title":"Methamphetamine causes sustained depression in cerebral blood flow","volume":"1373","author":"Polesskaya","year":"2011","journal-title":"Brain Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1177\/1756285609347123","article-title":"Diagnosis and treatment of cerebral vasculitis","volume":"3","author":"Berlit","year":"2010","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/01.paf.0000137206.16785.2f","article-title":"Spontaneous intracerebral hemorrhage related to methamphetamine abuse: Autopsy findings and clinical correlation","volume":"25","author":"McGee","year":"2004","journal-title":"Am. J. Forensic Med. Pathol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/j.1556-4029.2008.00949.x","article-title":"Involvement of amphetamines in sudden and unexpected death","volume":"54","author":"Pilgrim","year":"2009","journal-title":"J. Forensic Sci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1136\/jnnp-2017-316071","article-title":"Stroke and methamphetamine use in young adults: A review","volume":"88","author":"Lappin","year":"2017","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.4088\/JCP.15m09872","article-title":"Risk of Cardiovascular Diseases and Stroke Events in Methamphetamine Users: A 10-Year Follow-Up Study","volume":"77","author":"Huang","year":"2016","journal-title":"J. Clin. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s12024-013-9419-5","article-title":"Drug-induced bilateral ischemic infarction in an amphetamine addict","volume":"9","author":"Christensen","year":"2013","journal-title":"Forensic Sci. Med. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jns.2012.08.031","article-title":"3 cases of primary intracranial hemorrhage associated with \u201cMolly\u201d, a purified form of 3,4-methylenedioxymethamphetamine (MDMA)","volume":"323","author":"Kahn","year":"2012","journal-title":"J. Neurol. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s00415-018-8888-6","article-title":"Haemorrhagic stroke related to the use of 4-fluoroamphetamine","volume":"265","author":"Wijers","year":"2018","journal-title":"J. Neurol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jocn.2016.03.018","article-title":"Methamphetamine-related brainstem haemorrhage","volume":"32","author":"Chiu","year":"2016","journal-title":"J. Clin. Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1176\/appi.ajp.2010.10050703","article-title":"Hemorrhagic stroke in a patient recently started on mixed amphetamine salts","volume":"167","author":"Kapetanovic","year":"2010","journal-title":"Am. J. Psychiatry"},{"key":"ref_47","first-page":"265","article-title":"Cerebral vasospasm in patient with hemorrhagic stroke after amphetamine intake\u2014Case report","volume":"24","author":"Lyson","year":"2008","journal-title":"Pol. Merkur. Lek. Organ Pol. Tow. Lek."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/BF03161008","article-title":"Cerebrovascular accident following MDMA ingestion","volume":"2","author":"Muntan","year":"2006","journal-title":"J. Med. Toxicol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1212\/01.wnl.0000249180.61312.d3","article-title":"Carotid artery dissection and middle cerebral artery stroke following methamphetamine use","volume":"67","author":"McIntosh","year":"2006","journal-title":"Neurology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1136\/pgmj.2006.055970","article-title":"Cocaine use and stroke","volume":"83","author":"Treadwell","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e1169","DOI":"10.4088\/JCP.13r08525","article-title":"Antipsychotics for cocaine or psychostimulant dependence: Systematic review and meta-analysis of randomized, placebo-controlled trials","volume":"74","author":"Kishi","year":"2013","journal-title":"J. Clin. Psychiatry"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"5624","DOI":"10.2174\/092986712803988893","article-title":"Side effects of cocaine abuse: Multiorgan toxicity and pathological consequences","volume":"19","author":"Riezzo","year":"2012","journal-title":"Curr. Med. Chem."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.atherosclerosis.2017.03.019","article-title":"Vascular disease in cocaine addiction","volume":"262","author":"Bachi","year":"2017","journal-title":"Atherosclerosis"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugalcdep.2014.06.041","article-title":"Cocaine use and risk of stroke: A systematic review","volume":"142","author":"Sordo","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.02.017","article-title":"Clinical Profiles, Complications, and Disability in Cocaine-Related Ischemic Stroke","volume":"20","author":"Bhattacharya","year":"2011","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s12012-008-9025-z","article-title":"Molecular analysis of cocaine-induced endothelial dysfunction: Role of endothelin-1 and nitric oxide","volume":"8","author":"Pradhan","year":"2008","journal-title":"Cardiovasc. Toxicol."},{"key":"ref_57","first-page":"1532","article-title":"Cocaine-induced cerebrovasospasm and its possible mechanism of action","volume":"268","author":"He","year":"1994","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3217","DOI":"10.1364\/BOE.5.003217","article-title":"Optical coherence Doppler tomography for quantitative cerebral blood flow imaging","volume":"5","author":"You","year":"2014","journal-title":"Biomed. Opt. Express"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jstrokecerebrovasdis.2009.05.002","article-title":"Neurovascular Complications of Cocaine Use at a Tertiary Stroke Center","volume":"19","author":"Toossi","year":"2010","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.neulet.2013.03.045","article-title":"Peripheral toxicity in crack cocaine use disorders","volume":"544","author":"Narvaez","year":"2013","journal-title":"Neurosci. Lett."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1002\/hup.1251","article-title":"Immune system inflammation in cocaine dependent individuals: Implications for medications development","volume":"27","author":"Fox","year":"2012","journal-title":"Hum. Psychopharmacol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1161\/ATVBAHA.116.307985","article-title":"HIV, Cocaine Use, and Hepatitis C Virus: A Triad of Nontraditional Risk Factors for Subclinical Cardiovascular Disease","volume":"36","author":"Lucas","year":"2016","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1023\/A:1001988613235","article-title":"Hepatitis C virus infection in cocaine users\u2014A silent epidemic","volume":"36","author":"Harsch","year":"2000","journal-title":"Community Ment. Health J."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.3109\/10826084.2015.1023451","article-title":"Continued Substance Use Among People Living With HIV-Hepatitis-C Co-Infection and Receiving Antiretroviral Therapy","volume":"50","author":"Kalichman","year":"2015","journal-title":"Subst. Use Misuse"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.3389\/fmicb.2015.01111","article-title":"Impact of cocaine abuse on HIV pathogenesis","volume":"6","author":"Dash","year":"2015","journal-title":"Front. Microbiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1161\/CIRCRESAHA.116.308398","article-title":"Stroke Risk Factors, Genetics, and Prevention","volume":"120","author":"Boehme","year":"2017","journal-title":"Circ. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1002\/ana.21480","article-title":"Risk variants for atrial fibrillation on chromosome 4q25 associate with ischemic stroke","volume":"64","author":"Gretarsdottir","year":"2008","journal-title":"Ann. Neurol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/S0959-437X(99)80006-9","article-title":"Histone acetylases and deacetylases in cell proliferation","volume":"9","author":"Kouzarides","year":"1999","journal-title":"Curr. Opin. Genet. Dev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1111\/adb.12522","article-title":"Novel role and regulation of HDAC4 in cocaine-related behaviors","volume":"23","author":"Penrod","year":"2018","journal-title":"Addict. Biol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"3173","DOI":"10.1161\/STROKEAHA.109.556563","article-title":"Multi-ethnic genetic association study of carotid intima-media thickness using a targeted cardiovascular SNP microarray","volume":"40","author":"Lanktree","year":"2009","journal-title":"Stroke"},{"key":"ref_71","first-page":"e1536","article-title":"Impact of Cocaine Use on Acute Ischemic Stroke Patients: Insights from Nationwide Inpatient Sample in the United States","volume":"9","author":"Desai","year":"2017","journal-title":"Cureus"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1161\/STROKEAHA.115.011417","article-title":"Cocaine Use and Risk of Ischemic Stroke in Young Adults","volume":"47","author":"Cheng","year":"2016","journal-title":"Stroke"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1161\/01.STR.22.10.1320","article-title":"Central nervous system infarction related to cocaine abuse","volume":"22","author":"Daras","year":"1991","journal-title":"Stroke"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1161\/STROKEAHA.109.573147","article-title":"Intracerebral hemorrhage in cocaine users","volume":"41","author":"Albright","year":"2010","journal-title":"Stroke"},{"key":"ref_75","first-page":"9598675","article-title":"Limb Pain as Unusual Presentation of a Parietal Intraparenchymal Bleeding Associated with Crack Cocaine Use: A Case Report","volume":"2018","author":"Lucerna","year":"2018","journal-title":"Case Rep. Neurol. Med."},{"key":"ref_76","first-page":"e2576","article-title":"Cocaine Induced Bilateral Posterior Inferior Cerebellar Artery and Hippocampal Infarction","volume":"10","author":"Mullaguri","year":"2018","journal-title":"Cureus"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"207","DOI":"10.21615\/cesmedicina.31.2.10","article-title":"Ischemic stroke related to acute consumption of cocaine","volume":"31","author":"Berrouet","year":"2017","journal-title":"CES Medicina"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1007\/s10072-014-1779-4","article-title":"Intra-arterial thrombolysis in a young patient with cocaine-associated stroke","volume":"35","author":"Vidale","year":"2014","journal-title":"Neurol. Sci."},{"key":"ref_79","first-page":"159","article-title":"Bilateral haemorrhagic infarction of the globus pallidus after cocaine and alcohol intoxication","volume":"109","author":"Renard","year":"2009","journal-title":"Acta Neurol. Belg."},{"key":"ref_80","first-page":"316","article-title":"A cocaine-associated quadriplegia and motor aphasia after first use of cocaine","volume":"64","author":"Chodorowski","year":"2007","journal-title":"Przegl. Lek."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1161\/STROKEAHA.112.671347","article-title":"Cannabis-related stroke: Myth or reality?","volume":"44","author":"Wolff","year":"2013","journal-title":"Stroke"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Zou, S., and Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19030833"},{"key":"ref_83","first-page":"532","article-title":"Cannabinoid inhibition of adenylate cyclase. Pharmacology of the response in neuroblastoma cell membranes","volume":"26","author":"Howlett","year":"1984","journal-title":"Mol. Pharmacol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1038\/sj.ijo.0803272","article-title":"The pharmacology of cannabinoid receptors and their ligands: An overview","volume":"30","author":"Pertwee","year":"2006","journal-title":"Int. J. Obes."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000369776","article-title":"Ischaemic strokes with reversible vasoconstriction and without thunderclap headache: A variant of the reversible cerebral vasoconstriction syndrome?","volume":"39","author":"Wolff","year":"2015","journal-title":"Cerebrovasc. Dis."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/1753-6405.12477","article-title":"Heavy cannabis users at elevated risk of stroke: Evidence from a general population survey","volume":"40","author":"Hemachandra","year":"2016","journal-title":"Aust. N. Z. J. Public Health"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jns.2016.01.066","article-title":"Recreational marijuana use and acute ischemic stroke: A population-based analysis of hospitalized patients in the United States","volume":"364","author":"Rumalla","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"e138","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.04.017","article-title":"Large Amount of Cannabis Ingestion Resulting in Spontaneous Intracerebral Hemorrhage: A Case Report","volume":"26","author":"Atchaneeyasakul","year":"2017","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.lpm.2014.05.022","article-title":"Both hemorrhagic and ischemic stroke following high doses of cannabis consumption","volume":"44","author":"Ince","year":"2015","journal-title":"Presse Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1213\/01.ANE.0000131505.03006.74","article-title":"The procoagulatory effects of delta-9-tetrahydrocannabinol in human platelets","volume":"99","author":"Deusch","year":"2004","journal-title":"Anesth. Analg."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1055\/s-0038-1648084","article-title":"Impairment of ADP-Induced Platelet Aggregation by Hashish Components","volume":"36","author":"Levy","year":"1976","journal-title":"Thromb. Haemost."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1136\/pgmj.2008.070425","article-title":"Cannabis and stroke: Is there a link?","volume":"85","author":"Thanvi","year":"2009","journal-title":"Postgrad. Med. J."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1136\/jnnp.2004.042382","article-title":"Recurrent stroke associated with cannabis use","volume":"76","author":"Mateo","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/j.ijcard.2008.11.200","article-title":"Cannabis induced acute coronary syndrome in a young female","volume":"143","author":"Bailly","year":"2010","journal-title":"Int. J. Cardiol."},{"key":"ref_95","unstructured":"EMCDDA (2018). Medical Use of Cannabis and Cannabinoids: Questions and Answers for Policymaking, Publications Office of the European Union."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1161\/STROKEAHA.113.001562","article-title":"Cannabis, ischemic stroke, and transient ischemic attack: A case-control study","volume":"44","author":"Barber","year":"2013","journal-title":"Stroke"},{"key":"ref_97","first-page":"5313795","article-title":"Stroke from Vasospasm due to Marijuana Use: Can Cannabis Synergistically with Other Medications Trigger Cerebral Vasospasm?","volume":"2016","author":"Jamil","year":"2016","journal-title":"Case Rep. Neurol. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/1752-1947-5-264","article-title":"Stroke with neuropsychiatric sequelae after cannabis use in a man: A case report","volume":"5","author":"Trojak","year":"2011","journal-title":"J. Med. Case Rep."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1161\/STROKEAHA.110.610915","article-title":"Cannabis use, ischemic stroke, and multifocal intracranial vasoconstriction: A prospective study in 48 consecutive young patients","volume":"42","author":"Wolff","year":"2011","journal-title":"Stroke"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1988-e1","DOI":"10.1016\/j.ajem.2017.09.049","article-title":"Cannabis can augment thrombolytic properties of rtPA: Intracranial hemorrhage in a heavy cannabis user","volume":"35","author":"Shere","year":"2017","journal-title":"Am. J. Emerg. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/ADM.0000000000000326","article-title":"Multiple Cerebral Infarcts in a Young Patient Associated With Marijuana Use","volume":"11","author":"Volpon","year":"2017","journal-title":"J. Addict. Med."},{"key":"ref_102","first-page":"93","article-title":"Acute Antero-Inferior Wall Ischaemia with Acute Ischaemic Stroke Caused by Oral Ingestion of Cannabis in a Young Male","volume":"64","author":"Tirkey","year":"2016","journal-title":"J. Assoc. Physicians India"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1017\/S0317167100016711","article-title":"Cannabis use associated with capsular warning syndrome and ischemic stroke","volume":"41","author":"Baharnoori","year":"2014","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.04.002","article-title":"Cannabis-related myocardial infarction and cardioembolic stroke","volume":"21","author":"Renard","year":"2012","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.drugalcdep.2014.08.005","article-title":"Synthetic cannabinoids: Epidemiology, pharmacodynamics, and clinical implications","volume":"144","author":"Castaneto","year":"2014","journal-title":"Drug Alcohol Depend."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.pnpbp.2012.04.017","article-title":"Spice drugs are more than harmless herbal blends: A review of the pharmacology and toxicology of synthetic cannabinoids","volume":"39","author":"Seely","year":"2012","journal-title":"Prog. Neuropsychopharmacol. Biol. Psychiatry"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s40429-014-0014-y","article-title":"Synthetic Cannabinoids: Pharmacology, Behavioral Effects, and Abuse Potential","volume":"1","author":"Tai","year":"2014","journal-title":"Curr. Addict. Rep."},{"key":"ref_108","doi-asserted-by":"crossref","unstructured":"Brents, L.K., Reichard, E.E., Zimmerman, S.M., Moran, J.H., Fantegrossi, W.E., and Prather, P.L. (2011). Phase I hydroxylated metabolites of the K2 synthetic cannabinoid JWH-018 retain in vitro and in vivo cannabinoid 1 receptor affinity and activity. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0021917"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"2090","DOI":"10.1212\/01.wnl.0000437297.05570.a2","article-title":"Ischemic stroke after use of the synthetic marijuana \u201cspice\u201d","volume":"81","author":"Freeman","year":"2013","journal-title":"Neurology"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1212\/WNL.0000000000001973","article-title":"Hemorrhagic stroke following use of the synthetic marijuana \u201cspice\u201d","volume":"85","author":"Rose","year":"2015","journal-title":"Neurology"},{"key":"ref_111","first-page":"27","article-title":"Endocannabinoids and vascular function","volume":"294","author":"Hillard","year":"2000","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"72","DOI":"10.3109\/03602532.2013.839700","article-title":"The K2\/Spice phenomenon: Emergence, identification, legislation and metabolic characterization of synthetic cannabinoids in herbal incense products","volume":"46","author":"Brents","year":"2014","journal-title":"Drug Metab. Rev."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.07.030","article-title":"Synthetic cannabis and acute ischemic stroke","volume":"23","author":"Leung","year":"2014","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1016\/j.radcr.2018.02.023","article-title":"Acute carotid thrombosis and ischemic stroke following overdose of the synthetic cannabinoid K2 in a previously healthy young adult male","volume":"13","author":"Faroqui","year":"2018","journal-title":"Radiol. Case Rep."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"973","DOI":"10.3109\/15563650.2014.958614","article-title":"A case of acute cerebral ischemia following inhalation of a synthetic cannabinoid","volume":"52","author":"Takematsu","year":"2014","journal-title":"Clin. Toxicol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/FTD.0b013e3181c0eee0","article-title":"Poppy seed foods and opiate drug testing\u2014Where are we today?","volume":"32","author":"Lachenmeier","year":"2010","journal-title":"Ther. Drug Monit."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1080\/02791072.2016.1207826","article-title":"The Textures of Heroin: User Perspectives on \u201cBlack Tar\u201d and Powder Heroin in Two U.S. Cities","volume":"48","author":"Mars","year":"2016","journal-title":"J. Psychoact. Drugs"},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Freye, E., and Levy, J. (2008). Opioids in Medicine\u2014A Comprehensive Review on the Mode of Action and the Use of Analgesics in Different Clinical Pain States, Springer Science + Business Media BV.","DOI":"10.1007\/978-1-4020-5947-6"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"273","DOI":"10.2174\/1874473711205040003","article-title":"Clinical and forensic signs related to opioids abuse","volume":"5","author":"Carvalho","year":"2012","journal-title":"Curr. Drug Abus. Rev."},{"key":"ref_120","first-page":"201","article-title":"Urinary excretion of morphine and its metabolites in morphine-dependent subjects","volume":"192","author":"Yeh","year":"1975","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.toxlet.2014.10.026","article-title":"Contribution of human esterases to the metabolism of selected drugs of abuse","volume":"232","author":"Meyer","year":"2015","journal-title":"Toxicol. Lett."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s11910-012-0325-0","article-title":"Drug abuse and stroke","volume":"13","author":"Fonseca","year":"2013","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_123","first-page":"309","article-title":"Nuclear magnetic resonance tomography detection of heroin-associated CNS lesions","volume":"7","author":"Niehaus","year":"1997","journal-title":"Aktuelle Radiol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"iii9","DOI":"10.1136\/jnnp.2004.045732","article-title":"Recreational drugs and their neurological consequences","volume":"75","author":"Enevoldson","year":"2004","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jns.2015.06.031","article-title":"Multiple cerebral infarctions in a young patient with heroin-induced hypereosinophilic syndrome","volume":"356","author":"Bolz","year":"2015","journal-title":"J. Neurol. Sci."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/0303-8467(88)90036-4","article-title":"Neurological manifestations of the hypereosinophilic syndrome (HES)","volume":"90","author":"Prick","year":"1988","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_127","first-page":"6","article-title":"Relationship of opium dependency and stroke","volume":"1","author":"Khademizadeh","year":"2009","journal-title":"Addict. Health"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"1109-e3","DOI":"10.1016\/j.ajem.2015.01.007","article-title":"Intraparenchymal hemorrhage after heroin use","volume":"33","author":"Kumar","year":"2015","journal-title":"Am. J. Emerg. Med."},{"key":"ref_129","first-page":"145","article-title":"Bilateral globus pallidus lesions","volume":"164","author":"Alquist","year":"2012","journal-title":"J. La. State Med. Soc."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0303-8467(97)00088-7","article-title":"Ballistic movements due to ischemic infarcts after intravenous heroin overdose: Report of two cases","volume":"99","author":"Vila","year":"1997","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/jnnp.39.2.194","article-title":"Stroke associated with addiction to heroin","volume":"39","author":"Brust","year":"1976","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1093\/jjco\/hyt080","article-title":"Association of intensive morphine treatment and increased stroke incidence in prostate cancer patients: A population-based nested case-control study","volume":"43","author":"Lee","year":"2013","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_133","first-page":"95","article-title":"Frequency of Opium Addiction in Patients with Ischemic Stroke and Comparing their Cerebrovascular Doppler Ultrasound Changes to Non-Addicts","volume":"5","author":"Shafa","year":"2013","journal-title":"Addict. Health"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1080\/13554794.2012.667125","article-title":"Heroin inhalation-induced unilateral complete hippocampal stroke","volume":"19","author":"Benoilid","year":"2013","journal-title":"Neurocase"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1600-0447.2009.01378.x","article-title":"Rhabdomyolysis and brain ischemic stroke in a heroin-dependent male under methadone maintenance therapy","volume":"120","author":"Hsu","year":"2009","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"438","DOI":"10.2174\/138955711795445907","article-title":"Is there a potential immune dysfunction with anabolic androgenic steroid use: A review","volume":"11","author":"Brenu","year":"2011","journal-title":"Mini Rev. Med. Chem."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1747-597X-3-3","article-title":"Risk factors for alcohol and other drug use by healthcare professionals","volume":"3","author":"Kenna","year":"2008","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1136\/bjsm.2003.000199","article-title":"Effects of androgenic-anabolic steroids on apolipoproteins and lipoprotein (a)","volume":"38","author":"Hartgens","year":"2004","journal-title":"Br. J. Sports Med."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/WNF.0b013e3180ed4485","article-title":"Ischemic stroke related to anabolic abuse","volume":"31","author":"Santamarina","year":"2008","journal-title":"Clin. Neuropharmacol."},{"key":"ref_140","doi-asserted-by":"crossref","unstructured":"Shamloul, R.M., Aborayah, A.F., Hashad, A., and Abd-Allah, F. (2014). Anabolic steroids abuse-induced cardiomyopathy and ischaemic stroke in a young male patient. BMJ Case Rep., 2014.","DOI":"10.1136\/bcr-2013-203033"},{"key":"ref_141","doi-asserted-by":"crossref","unstructured":"Youssef, M.Y., Alqallaf, A., and Abdella, N. (2011). Anabolic androgenic steroid-induced cardiomyopathy, stroke and peripheral vascular disease. BMJ Case Rep., 2011.","DOI":"10.1136\/bcr.12.2010.3650"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/0002-9149(86)90392-9","article-title":"Left ventricular diastolic function in weight lifters","volume":"58","author":"Pearson","year":"1986","journal-title":"Am. J. Cardiol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1055\/s-0031-1297371","article-title":"Doping and thrombosis in sports","volume":"37","author":"Lippi","year":"2011","journal-title":"Semin. Thromb. Hemost."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jsbmb.2004.11.003","article-title":"Effects of chronic anabolic steroid treatment on tonic and reflex cardiovascular control in male rats","volume":"93","author":"Beutel","year":"2005","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.3109\/10826084.2014.903751","article-title":"Adverse cardiovascular effects from the use of anabolic-androgenic steroids as ergogenic resources","volume":"49","author":"Santos","year":"2014","journal-title":"Subst. Use Misuse"},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.amjcard.2010.05.013","article-title":"Cardiac and metabolic effects of anabolic-androgenic steroid abuse on lipids, blood pressure, left ventricular dimensions, and rhythm","volume":"106","author":"Achar","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.toxlet.2006.12.008","article-title":"Detrimental effects of anabolic steroids on human endothelial cells","volume":"169","author":"Millimaggi","year":"2007","journal-title":"Toxicol. Lett."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"513","DOI":"10.2165\/00007256-200434080-00003","article-title":"Effects of androgenic-anabolic steroids in athletes","volume":"34","author":"Hartgens","year":"2004","journal-title":"Sports Med."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1210\/er.2003-0005","article-title":"Androgens and cardiovascular disease","volume":"24","author":"Liu","year":"2003","journal-title":"Endocr. Rev."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"H3575","DOI":"10.1152\/ajpheart.01251.2006","article-title":"Anabolic steroids induce cardiac renin-angiotensin system and impair the beneficial effects of aerobic training in rats","volume":"293","author":"Rocha","year":"2007","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1249\/MSS.0b013e318217e8b6","article-title":"Anabolic steroid associated to physical training induces deleterious cardiac effects","volume":"43","author":"Fernandes","year":"2011","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijcard.2018.05.051","article-title":"Genetic predictors of testosterone and their associations with cardiovascular disease and risk factors: A Mendelian randomization investigation","volume":"267","author":"Schooling","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1111\/bju.14149","article-title":"Impact of testosterone replacement therapy on thromboembolism, heart disease and obstructive sleep apnoea in men","volume":"121","author":"Cole","year":"2018","journal-title":"BJU Int."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1002\/ana.21840","article-title":"Role of endogenous testosterone concentration in pediatric stroke","volume":"66","author":"Normann","year":"2009","journal-title":"Ann. Neurol."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1210\/jc.2018-00229","article-title":"Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline","volume":"103","author":"Bhasin","year":"2018","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_156","first-page":"161","article-title":"Adolescent ischemic stroke associated with anabolic steroid and cannabis abuse","volume":"26","author":"Weber","year":"2013","journal-title":"J. Pediatr. Endocrinol. Metab."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1161\/01.CIR.94.9.2057","article-title":"Fibrinolytic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. ECAT Study Group. European Concerted Action on Thrombosis and Disabilities","volume":"94","author":"Pyke","year":"1996","journal-title":"Circulation"},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1080\/02713683.2016.1276197","article-title":"Plasminogen Activator Inhibitor Type-1 Tag Single-Nucleotide Polymorphisms in Patients with Diabetes Mellitus Type 2 and Diabetic Retinopathy","volume":"42","author":"Siokas","year":"2017","journal-title":"Curr. Eye Res."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0378-5122(96)82004-4","article-title":"Effects of androgens on haemostasis","volume":"24","author":"Winkler","year":"1996","journal-title":"Maturitas"},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1093\/oxfordjournals.eurheartj.a014724","article-title":"Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters","volume":"17","author":"Nieminen","year":"1996","journal-title":"Eur. Heart J."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/0039-128X(90)90058-J","article-title":"Sex hormones and coronary disease: A review of the clinical studies","volume":"55","author":"Kalin","year":"1990","journal-title":"Steroids"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"4743","DOI":"10.1210\/jc.2010-0864","article-title":"Testosterone suppresses hepcidin in men: A potential mechanism for testosterone-induced erythrocytosis","volume":"95","author":"Bachman","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1093\/gerona\/glt154","article-title":"Testosterone induces erythrocytosis via increased erythropoietin and suppressed hepcidin: Evidence for a new erythropoietin\/hemoglobin set point","volume":"69","author":"Bachman","year":"2014","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1182\/asheducation-2010.1.30","article-title":"Telomere biology and telomere diseases: Implications for practice and research","volume":"2010","author":"Young","year":"2010","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program"},{"key":"ref_165","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.fct.2018.03.043","article-title":"Use of nutritional supplements contaminated with banned doping substances by recreational adolescent athletes in Athens, Greece","volume":"115","author":"Tsarouhas","year":"2018","journal-title":"Food Chem. Toxicol. Int. J. Publ. Br. Ind. Biol. Res. Assoc."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1123\/ijsnem.21.5.377","article-title":"The use of nutritional supplements among recreational athletes in Athens, Greece","volume":"21","author":"Tsitsimpikou","year":"2011","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.toxlet.2015.10.026","article-title":"Cardiotoxicity in rabbits after long-term nandrolone decanoate administration","volume":"241","author":"Vasilaki","year":"2016","journal-title":"Toxicol. Lett."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1161\/CIRCHEARTFAILURE.109.931063","article-title":"Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction","volume":"3","author":"Baggish","year":"2010","journal-title":"Circ. Heart Fail."},{"key":"ref_169","first-page":"1268","article-title":"Effects of pharmacological doses of nandrolone decanoate and progressive resistance training in immunodeficient patients infected with human immunodeficiency virus","volume":"84","author":"Sattler","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_170","doi-asserted-by":"crossref","first-page":"906-e9","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.07.013","article-title":"Cerebral Infarction in a Young Man Using High-dose Anabolic Steroids","volume":"21","author":"Shimada","year":"2012","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1136\/bjsm.2006.030171","article-title":"Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: A Doppler myocardial and strain imaging analysis","volume":"41","author":"Caso","year":"2007","journal-title":"Br. J. Sports Med."},{"key":"ref_172","first-page":"327","article-title":"[Ingestion of anabolic steroids and ischaemic stroke. A clinical case report and review of the literature]","volume":"56","author":"Davalos","year":"2013","journal-title":"Rev. Neurol."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1111\/imj.13029","article-title":"Anabolic androgenic steroids, an easily forgotten cause of polycythaemia and cerebral infarction","volume":"46","author":"Low","year":"2016","journal-title":"Intern. Med. J."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"e000638","DOI":"10.1161\/JAHA.113.000638","article-title":"Cannabis use: Signal of increasing risk of serious cardiovascular disorders","volume":"3","author":"Jouanjus","year":"2014","journal-title":"J. Am. Heart Assoc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/9\/1295\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:13:36Z","timestamp":1760188416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/9\/1295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,23]]},"references-count":174,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["jcm8091295"],"URL":"https:\/\/doi.org\/10.3390\/jcm8091295","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,23]]}}}