Abstract 2- 0900-0915
Category: Clinical

At the end of the session,
participants will be able to:

  1. To be aware of the severe impact of prenatal exposure to cocaine on the developing brain
  2. To identify the lesions resulting from a direct toxicity of cocaine.

COI Disclosure:

None to disclose


Catharine Fallet_Bianco
Neuropathologist (CHU Sainte-Justine)
Full Clinician Professor (Université de Montréal)
Certification in Neurology, Fetal Pathology and Dysmorphology in genetics
Clinical and research interest are in Developmental and Pediatric Neuropathology, Neuropathology of epilepsy


Catherine Fallet-Bianco*, Mubina Jovanovic*, Dorothée Bouron- Dal Soglio*.

*Department of Pathology, Hôpital Sainte-Justine-Université de Montreal, Montreal (QC), Canada

Target Audience:
Pathologists, Other – Write In (Required): Neuropathologists


Effects of prenatal cocaine exposure on the human developing brain. A neuropathological study


Recent studies report that cocaine use among pregnant women continues to be a public health concern. Experimental studies have shown that prenatal cocaine exposure is responsible for disturbances affecting neurogenesis, neuronal migration and neurotransmitter systems. However, human-based studies are impacted by confounding factors: multi-drug use, lack of neuropathological studies.

We describe the neuropathological phenotype observed in two fetuses after prenatal exposure to cocaine. In a 34-year-old woman using cocaine for several years, ultrasonography at 24 gestational weeks revealed a severe microcephaly with a severe global disorganization of brain development. In the second case, a 19-year-old mother using cocaine, ultrasonography at 20 weeks showed a severe microcephaly with bilateral schizencephaly resulting from multiple hemorrhages.

A vasoconstriction of maternal-fetal arteries is, classically, the mechanism considered responsible for the disturbed brain development.  A vascular disruption is probably the cause of the lesions in the second case. The changes in the first case are similar to those generated in experimental models and confirm that cocaine has direct toxic effects on the neurogenesis, gliogenesis and neuronal migration in the developing brain. The wide spectrum of brain lesions depends on multiple factors; the most important is probably the moment of exposure in gestation, as well as dose, frequency of cocaine use, and genetic susceptibility.