Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 5 ( September-October, 2023 ) > List of Articles

CASE REPORT

Stroke of Misfortune: Unpacking the Association between Cannabis and Young Stroke

Ujjawal Shriwastav, Arnab Choudhury, Sahil Kumar, Jithesh Gangadharan, Mukesh Bairwa, Dhiri R Pradhan

Keywords : Arterial thrombosis, Case report, Posterior circulation, Tetrahydrocannabinol, Young stroke

Citation Information : Shriwastav U, Choudhury A, Kumar S, Gangadharan J, Bairwa M, Pradhan DR. Stroke of Misfortune: Unpacking the Association between Cannabis and Young Stroke. 2023; 2 (5):128-131.

DOI: 10.5005/jp-journals-11006-0072

License: CC BY-NC 4.0

Published Online: 27-10-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

This case study presents a rare case of a 21-year-old male with a posterior circulation stroke solely due to cannabis use disorder. The patient presented with a sudden onset of vomiting and headache, which progressed to include neurological deficits such as facial palsy and limb weakness. Imaging revealed acute nonhemorrhagic infarcts in the pons, medulla, and cerebellar hemispheres and thrombosis in the right vertebral and partial eccentric thrombosis of the basilar artery. The patient tested positive for tetrahydrocannabinol (THC), the active ingredient in cannabis. While stroke is more common in older adults, the incidence of stroke in young adults has increased by several folds in recent decades. Stroke in the young poses unique diagnostic challenges as risk factors vary and are different compared to those in the classical older population. Illicit substance abuse is one of the important risk factors in young stroke. This case highlights the importance of recognizing cannabis use disorder as a risk factor for stroke in young adults and the need for further research into the link between cannabis use disorder and stroke.


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  1. Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int J Stroke 2022;17(1):18–29. DOI: 10.1177/17474930211065917
  2. Griffiths D, Sturm J. Epidemiology and etiology of young stroke. Stroke Res Treat 2011;2011:209370. DOI: 10.4061/2011/209370
  3. Krishnamurthi RV, Moran AE, Feigin VL, et al. Stroke prevalence, mortality and disability-adjusted life years in adults aged 20-64 years in 1990-2013: data from the global burden of disease 2013 study. Neuroepidemiology 2015;45(3):190–202. DOI: 10.1159/000441098
  4. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392(10159):1736–1788. DOI: 10.1016/S0140-6736(18)32203-7
  5. Dalal PM. Burden of stroke–Indian perspective. J Assoc Physicians India 2004;52:695–696. DOI: 10.1111/j.1747-4949.2006.00051.x
  6. Boot E, Ekker MS, Putaala J, et al. Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry 2020;91(4):411–417. DOI: 10.1136/jnnp-2019-322424
  7. Mani J, Garg N, Bhattacharya M, et al. Young stroke in a tertiary care hospital in India: Risk factors, subtypes, and outcome. Ann Indian Acad Neurol 2020;23(6):695–700. DOI: 10.4061/2011/368629
  8. Ministry of Social Justice and Empowerment. National Survey on Drug Use and. Health in India. 2019. Available from: https://www.drugabuse.gov/international/abstracts/national-survey-drug-use-health-india-2019. [Accessed 10 May 2023].
  9. Deusch E, Kress HG, Kraft B, et al. The procoagulatory effects of delta-9-tetrahydrocannabinol in human platelets. Anesth Analg 2004;99(4):1127–1130. DOI: 10.1213/01.ANE.0000131505.03006.74
  10. Marchetti D, Spagnolo A, De Matteis V, et al. Coronary thrombosis and marijuana smoking: a case report and narrative review of the literature. Drug Test Anal 2016;8(1):56–62. DOI: 10.1002/dta.1898
  11. Elikowski W, Małek M, Kurosz J, et al. Severe pulmonary embolism in a young marijuana smoker. Kardiol Pol 2011;69(11):1168–1170. https://pubmed.ncbi.nlm.nih.gov/22090230
  12. Patel RS, Gonzalez MD, Ajibawo T, et al. Cannabis use disorder and increased risk of arrhythmia-related hospitalization in young adults. Am J Addict 2021;30(6):578–584. DOI: 10.1111/ajad.13215
  13. Wolff V, Armspach JP, Beaujeux R, et al. High frequency of intracranial arterial stenosis and cannabis use in ischaemic stroke in the young. Cerebrovasc Dis 2014;37(6):438–443. DOI: 10.1159/000363618
  14. Desai R, Singh S, Patel K, et al. Stroke in young cannabis users (18–49 years): national trends in hospitalizations and outcomes. Int J Stroke 2020;15(5):535–539. DOI: 10.1177/1747493019895651
  15. Hackam DG. Cannabis and stroke: systematic appraisal of case reports. Stroke 2015;46(3):852–856. DOI: 10.1161/STROKEAHA.115.008680
  16. Swetlik C, Migdady I, Hasan LZ, et al. Cannabis use and stroke: does a risk exist? J Addict Med 2022;16(2):208–215. DOI: 10.1097/ADM.0000000000000870
  17. Bal S, Khurana D, Lal V, et al. Posterior circulation stroke in a cannabis abuser. Neurol India 2009;57(1):91–92. DOI: 10.4103/0028-3886.48797
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