Consumption of Cannabis as a Risk Factor for Ischemic Stroke – a Case Report


Authors: L. Loudová 1;  L. Martinkovič 2;  J. Mikuláš 3;  J. Kasík 1
Authors‘ workplace: Neurologické oddělení, ÚVN – Vojenská fakultní nemocnice Praha 1;  Neurologická klinika 2. LF UK a FN v Motole, Praha 2;  Psychiatrické oddělení, ÚVN – Vojenská fakultní nemocnice Praha 3
Published in: Cesk Slov Neurol N 2013; 76/109(5): 637-640
Category: Case Report

Overview

Introduction:
The association between chronic use of cannabis and ischemic stroke has not been firmly established. Cases have been reported of ischemic stroke after consumption of cannabis. The proposed aetiological mechanisms of such stroke include cerebral vasoconstriction syndrome, paroxysmal atrial fibrillation, systemic hypotension and cerebral vasculitis.

Case study:
We present a case of 27-year-old man, chronic cannabis user who deve­loped acute ischemia in the posterior brain circulation. In the discussion, we discuss possible pathogenetic mechanisms of stroke after cannabis consumption.

Conclusion:
There appears to be a link between marihuana consumption and an onset of ischaemic stroke, although we cannot fully exclude other aetiologies. Therefore, we recommend routine toxicology examination in all young patients with stroke.

Key words:
cannabinoids – ischemic stroke – vasospasms

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Putaala J, Metso AJ, Metso TM, Kaste M, Tatlisumak T, Konkola N et al. Analysis of 1,008 consecutive patients Aged 15 to 49 with first‑ ever ischemic stroke: the Helsinki young stroke registry. Stroke 2009; 40(4): 2698– 2703.

2. Sloan M, Kittner S, Feeser BR, Gardner J, Epstein A,Wozniak MA et al. Illicit drug‑associated ischemic stroke in the Baltimore‑Washington Young Stroke Study. Neurology 1998; 50(6): 1688– 1693.

3. Mateo I, Pinedo A, Gomez‑ Beldarrain M, Basterretxea JM, Garcia‑ Monco JC. Recurrent stroke associated with cannabis use. J Neurol Neurosurg Psychiatry 2005; 76(3): 435– 437.

4. Thanvi BR, Treadwell SD. Cannabis and stroke: is there a link? Postgrad Med J 2009; 85(1000): 80– 83.

5. Singla S, Sachdeva R, Mehta JL. Cannabinoids and atherosclerotic coronary heart disease. Clin Cardiol 2012; 35(6): 329– 335.

6. Singh NN, Pan Y, Muengtaweeponsa S, Geller JT, Cruz‑ Flores S. Cannabis‑related stroke: case series and review of literature. J Stroke Cerebrovasc Dis 2012; 21(7): 555– 560.

7. Wolff V, Lauer V, Rouyer O, Sellal F, Meyer N, Raul JS et al. Cannabis use, ischemic stroke, and multifocal intracranial vasoconstriction: a prospective study in 48 consecutive young patients. Stroke 2011; 42(6): 1778– 1780.

8. Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain 2007; 30(12): 3091– 3101.

9. Martín‑ Santos R, Fagundo AB, Crippa JA, Atakan Z,Bhattacharyya S, Allen P et al. Neuroimaging in cannabis use: a systematic review of the literature. Psychol Med 2010; 40(3): 383– 398.

10. Disdier P, Granel B, Serratrice J, Constans J, Michon‑ Pasturel U, Hachulla E et al. Cannabis arteritis revisited: ten new case reports. Angiology 2001; 52(1): 1– 5.

Labels
Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 5

2013 Issue 5

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