Cannabis Use and Cerebrovascular Disease

Moussouttas, Michael

doi:10.1097/01.nrl.0000107493.19282.b0

Cited by 56 publications

(36 citation statements)

References 40 publications

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“…Since 1987, fewer than 25 cases of IS associated with cannabis smoking have been published. 2,3,4,5,6,7 As in our study, IS were more frequent in vertebrobasilar territory, suggesting susceptibility of posterior circulation. 2,3,4 Concomitant alcohol consumption 3 or unusually high consumption of cannabis were regarded as possible precipitating factors.…”

Section: Discussionsupporting

confidence: 70%

Cannabis Use, Ischemic Stroke, and Multifocal Intracranial Vasoconstriction

Wolff

Lauer

Rouyer

et al. 2011

Stroke

176

120

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Background and Purpose-Our objective was to evaluate the relationship between cannabis use and ischemic stroke in a young adult population. Methods-Forty-eight consecutive young patients admitted for acute ischemic stroke participated in the study. First-line screening was performed, including blood tests, cardiovascular investigations, and urine analysis for cannabinoids. If no etiology was found, 3D rotational angiography and cerebrospinal fluid analysis were performed. A control was planned through neurovascular imaging within 3 to 6 months. Results-In this series, there was multifocal intracranial stenosis associated with cannabis use in 21% (nϭ10). Conclusions-Multifocal MethodsFrom October 2005 to September 2007, 48 consecutive patients younger than 45 years of age who were admitted to our stroke unit for IS were included in this study. Patients were informed that they were included in a prospective study and agreed to participate. Standard T1, T2, FLAIR sequences, diffusion weighted-imaging magnetic resonance imaging scans were acquired for all patients. Vascular imaging comprised 3D-time of flight magnetic resonance angiography (nϭ43) or cerebral computed tomography angiography (nϭ5). Cardiac explorations included electrocardiogram (nϭ48), transthoracic echocardiography (nϭ48), and transoesophageal echocardiography (nϭ29). Exhaustive laboratory analyses were performed for all patients. If first-line investigations were inconclusive, 3D rotational angiography (nϭ30) and cerebrospinal fluid analysis (nϭ29) were performed. A questionnaire was used to determine cardiovascular risk factors, history of medication, and illicit drug or alcohol use. Urines were systematically screened for cannabinoids, cocaine, amphetamine, and methylenedioxymethamphetamine. Follow-up clinical visits (nϭ44) and control of vascular imaging (nϭ20) were planned within 3 to 6 months after discharge from hospital.One study neurologist and 1 study radiologist separately reviewed all 3D-time of flight or computed tomography angiography images. A single operator performed all 3D rotational angiography, and 2 study radiologists, who were unaware of magnetic resonance angiography results, reviewed the 3D rotational angiography images. Involvement of single or several vessel segments were respectively classified as monoarterial stenosis or as multifocal intracranial stenosis (MIS). Statistical AnalysisData are summarized using descriptive statistics. Because of sparseness of data, computations of odds ratio and 95% CI, as well as multivariate logistic regression, were obtained using exact methods (StatXact and LogXact). The logistic regression was designed using the group of MIS as the dependent variable and the other variables as potential predictors. A probability value Յ5% was considered statistically significant. ResultsTable displays the relationship between stroke etiology, classical risk factors, and cannabis use in the 48 patients. There were no patients undergoing serotonergic medical treatment, and there were no amphetamine, meth...

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Section: Discussionsupporting

confidence: 70%

Cannabis Use, Ischemic Stroke, and Multifocal Intracranial Vasoconstriction

Wolff

Lauer

Rouyer

et al. 2011

Stroke

176

120

View full text Add to dashboard Cite

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“…We have included articles published in English, French, Spanish, and those from our own files. There are 59 cannabis-related stroke cases [11][12][13][14][15][16][17] in 30 published articles including 4 reviews 3,13,14,16 and only 1 report linking cannabis use and cardiovascular events. …”

mentioning

confidence: 99%

Cannabis-related Stroke

Wolff

Armspach

Lauer

et al. 2013

Stroke

113

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“…6,7 The major psychoactive compound is ␦-9-tetrahydrocannabinol, which is a lipid-soluble substance that causes activation of the CB receptors. The CB receptors are heterogeneously distributed in the brain, with the highest densities in the basal ganglia, substantia nigra, globus pallidus, dentate gyrus of hippocampus, limbic cortices, and cerebellum.…”

Section: Cannabismentioning

confidence: 99%

Addictive Illegal Drugs: Structural Neuroimaging

Geibprasert¹,

Gallucci²,

Krings³

2009

AJNR Am J Neuroradiol

102

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SUMMARY:Illegal addictive drugs can lead to functional or structural impairment of the central nervous system. This review provides an overview of the structural imaging findings on CT, MR imaging, and conventional angiography related to chronic and acute abuse of the most commonly abused illegal drugs, including cannabis, organic solvents, and amphetamines and opioids and their respective derivatives. Pathomechanisms include excitotoxicity, which may lead to an acute or subacute leukoencephalopathy, and vascular complications, including vasoconstriction, vasculitis, or hypertension, which may lead to intracranial hemorrhage or ischemia. Because clinical findings alone are often nonspecific, and afflicted patients are unlikely to admit to the substance abuse, the neuroradiologist may play an important role in establishing the diagnosis and, thereby, initiating treatment.ABBREVIATIONS: CB ϭ cannabinoid; 5-HT ϭ serotonin (5-hydroxytryptamine); MCA ϭ middle cerebral artery; MDMA ϭ 3,4-methylenedioxymethamphetamine; MRA ϭ MR angiography; PET ϭ positron-emission tomography

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Cannabis Use and Cerebrovascular Disease

Cited by 56 publications

References 40 publications

Cannabis Use, Ischemic Stroke, and Multifocal Intracranial Vasoconstriction

Cannabis Use, Ischemic Stroke, and Multifocal Intracranial Vasoconstriction

Cannabis-related Stroke

Addictive Illegal Drugs: Structural Neuroimaging

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