Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke

Inal, Taylan; Köse, Ataman; Köksal, Özlem; Armağan, Erol; Aydın, Şule; Özdemir, Fatma Nurhan

doi:10.5847/wjem.j.issn.1920-8642.2014.01.013

Cited by 14 publications

(5 citation statements)

References 12 publications

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“…In the light of the foregoing cellular changes it would seem that the quality of cannabinoid-exposed gametes may be broadly seen as defective and they may thus be said in general terms to likely be "aged" in metabolic, epigenetic and genetic terms. Cannabinoids are known to have important effects on the microvasculature and can induce tissue ischaemia [102][103][104][105] which is an important determinant of the hypoxic microenvironment which stimulates genomic instability and oncogenesis and promotes nascent and mature tumour growth.…”

Section: Pathways and Mechanismsmentioning

confidence: 99%

A geospatiotemporal and causal inference epidemiological exploration of substance and cannabinoid exposure as drivers of rising US pediatric cancer rates

Reece

Hulse

2021

BMC Cancer

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Background Age-adjusted US total pediatric cancer incidence rates (TPCIR) rose 49% 1975–2015 for unknown reasons. Prenatal cannabis exposure has been linked with several pediatric cancers which together comprise the majority of pediatric cancer types. We investigated whether cannabis use was related spatiotemporally and causally to TPCIR. Methods State-based age-adjusted TPCIR data was taken from the CDC Surveillance, Epidemiology and End Results cancer database 2003–2017. Drug exposure was taken from the nationally-representative National Survey of Drug Use and Health, response rate 74.1%. Drugs included were: tobacco, alcohol, cannabis, opioid analgesics and cocaine. This was supplemented by cannabinoid concentration data from the Drug Enforcement Agency and ethnicity and median household income data from US Census. Results TPCIR rose while all drug use nationally fell, except for cannabis which rose. TPCIR in the highest cannabis use quintile was greater than in the lowest (β-estimate = 1.31 (95%C.I. 0.82, 1.80), P = 1.80 × 10− 7) and the time:highest two quintiles interaction was significant (β-estimate = 0.1395 (0.82, 1.80), P = 1.00 × 10− 14). In robust inverse probability weighted additive regression models cannabis was independently associated with TPCIR (β-estimate = 9.55 (3.95, 15.15), P = 0.0016). In interactive geospatiotemporal models including all drug, ethnic and income variables cannabis use was independently significant (β-estimate = 45.67 (18.77, 72.56), P = 0.0009). In geospatial models temporally lagged to 1,2,4 and 6 years interactive terms including cannabis were significant. Cannabis interactive terms at one and two degrees of spatial lagging were significant (from β-estimate = 3954.04 (1565.01, 6343.09), P = 0.0012). The interaction between the cannabinoids THC and cannabigerol was significant at zero, 2 and 6 years lag (from β-estimate = 46.22 (30.06, 62.38), P = 2.10 × 10− 8). Cannabis legalization was associated with higher TPCIR (β-estimate = 1.51 (0.68, 2.35), P = 0.0004) and cannabis-liberal regimes were associated with higher time:TPCIR interaction (β-estimate = 1.87 × 10− 4, (2.9 × 10− 5, 2.45 × 10− 4), P = 0.0208). 33/56 minimum e-Values were > 5 and 6 were infinite. Conclusion Data confirm a close relationship across space and lagged time between cannabis and TPCIR which was robust to adjustment, supported by inverse probability weighting procedures and accompanied by high e-Values making confounding unlikely and establishing the causal relationship. Cannabis-liberal jurisdictions were associated with higher rates of TPCIR and a faster rate of TPCIR increase. Data inform the broader general consideration of cannabinoid-induced genotoxicity.

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Section: Pathways and Mechanismsmentioning

confidence: 99%

A geospatiotemporal and causal inference epidemiological exploration of substance and cannabinoid exposure as drivers of rising US pediatric cancer rates

Reece

Hulse

2021

BMC Cancer

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“…19 Other mechanisms suggested a toxic or an immune mediated inflammatory vasculopathy; or even a vasospastic reaction directly from cannabis, or as a reflex reaction due to systemic hypotension. [19][20][21][22][23][24][25][26][27][28] One report proved the mechanism of vasospasm by identifying a subset of young patients who presented with stroke due to multifocal cerebral arterial stenosis, which was fully reversible; cannabis was a major precipitating risk factor among them. 29 Another possible mechanism could be the role of oxidative stress on brain mitochondrial function.…”

Section: Discussionmentioning

confidence: 99%

Recovery from spinal cord infarction associated with cannabis use

Akel

2017

The Journal of Spinal Cord Medicine

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“…ere were 23 studies identified that included patients presenting with cannabis induced ischemic stroke [Table 4]. [3,6,11,16,17,19,21,27,29,39,44,50,[57][58][59]61,63,64,[67][68][69]71,72] Demographic information was available in 22 articles for a total of 44 patients (10/44 [23%] female) with a median age of 28 years. All included studies described clinical presentation for the 184 total patients, which consisted of headache (2%), speech disturbance (64%), abnormal sensation/ motor function (38%), and visual disturbance (14%).…”

Section: Cannabismentioning

confidence: 99%

Effect of drug use in the treatment of acute ischemic stroke: A scoping review

Dabhi¹,

Mastorakos²,

Sokolowski³

et al. 2022

Surgical Neurology International

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Background: Drugs of abuse have been associated with ischemic stroke; however, the clinical presentation, outcomes, and treatment data in this population are limited. The overall safety and efficacy of thrombolytic therapy and thrombectomy in these patients remain unclear. This scoping review summarizes published complications and clinical outcomes in patients with recent abuse of cocaine, methamphetamine (MA), cannabis, decongestant, opioids, alcohol, and 3,4-methylenedioxymethamphetamine (MDMA) presenting with acute ischemic stroke. Methods: We conducted a scoping review of the primary literature that assessed outcomes data of thrombolytic therapy or thrombectomy in drug users with acute ischemic stroke. We searched PubMed, Ovid Medline, and Web of Science. Demographic and stroke characteristics, treatment, complications, and clinical outcomes at last follow-up were collected and summarized. Results: We identified 51 studies in this review. Drugs of abuse of interest were cocaine (14 studies), MDMA (one study), MA (eight studies), cannabis (23 studies), alcohol (two studies), decongestants (one study), and opioids (two studies). Clinical presentation and stroke presentation were most commonly described features. Thrombectomy outcomes were reported for four patients total (two studies), all with history of cocaine use. Thrombolysis treatment and outcomes were reported for 8851 patients (five studies) with history of cocaine, alcohol, or cannabis. Both treatments were pursued in three patients (three studies). Treatment complications included intracerebral hemorrhage, vasospasm, and cerebral edema. Conclusion: Evidence for thrombolytic and thrombectomy treatment in drug users remains limited. Controlled studies are needed to examine complication profile and outcomes following thrombolytic and thrombectomy treatment in this population.

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Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke

Cited by 14 publications

References 12 publications

A geospatiotemporal and causal inference epidemiological exploration of substance and cannabinoid exposure as drivers of rising US pediatric cancer rates

A geospatiotemporal and causal inference epidemiological exploration of substance and cannabinoid exposure as drivers of rising US pediatric cancer rates

Recovery from spinal cord infarction associated with cannabis use

Effect of drug use in the treatment of acute ischemic stroke: A scoping review

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