Tuesday, April 29, 2003 :::
 

Lester Brown was a large man, at least 6 feet 2 inches and 240 pounds. Even asleep he looked menacingly big, someone you didn't want to wake up before he was ready. The day he was brought to the Emergency Department you could have shook and pinched and tickled Mr. Brown and he wouldn't bother you. He had a ruptured blood vessel at the base of his brain.

It started at home. A few minutes after snorting some cocaine his posterior communicating cerebral artery began to pulsate, causing him to complain of "the worst headache of my life." Seconds later he fell to the floor, unconscious. En route to the emergency department the artery burst and he suffered a full blown subarachnoid hemorrhage. The loss of an ounce of blood into the surrounding brain tissue relieved the arterial pressure and the hemorrhage ceased, but by then it was too late. Irritating blood washed over the normally smooth brain surfaces where it didn't belong and in the process shut down his central nervous system, or at least the part responsible for consciousness. Lester Brown lapsed into a deep coma.

Mr. Brown was 41 years old and had been using cocaine for six or seven years. Like all cocaine-related knockouts, Lester's occurred not from a steady accretion of drug but from a single, exciting snort. Within 30 minutes after inhaling the cocaine he was in our ED, comatose and intubated, his breathing fully supported by a ventilator.

::: posted by Esamurai at 11:41 PM

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