Historique
Article de Périodique
Cannabis and stroke: systematic appraisal of case reports (2015)
Auteur(s) :
HACKAM, D. G.
Année
2015
Page(s) :
852-856
Sous-type de document :
Revue de la littérature / Literature review
Langue(s) :
Anglais
Refs biblio. :
39
Domaine :
Drogues illicites / Illicit drugs
Discipline :
PAT (Pathologie organique / Organic pathology)
Thésaurus mots-clés
ETUDE DE CAS
;
CANNABIS
;
CERVEAU
;
APPAREIL CARDIOVASCULAIRE
;
PATHOLOGIE ORGANIQUE
;
FACTEUR DE RISQUE
;
INFARCTUS
Résumé :
BACKGROUND AND PURPOSE: An increasing number of case reports link cannabis consumption to cerebrovascular events. Yet these case reports have not been scrutinized using criteria for causal inference.
METHODS: All case reports on cannabis and cerebrovascular events were retrieved. Four causality criteria were addressed: temporality, adequacy of stroke work-up, effects of rechallenge, and concomitant risk factors that could account for the cerebrovascular event.
RESULTS: There were 34 case reports on 64 patients. Most cases (81%) exhibited a temporal relationship between cannabis exposure and the index event. In 70%, the evaluation was sufficiently comprehensive to exclude other sources for stroke. About a quarter (22%) of patients had another stroke after subsequent re-exposure to cannabis. Finally, half of patients (50%) had concomitant stroke risk factors, most commonly tobacco (34%) and alcohol (11%) consumption.
CONCLUSIONS: Many case reports support a causal link between cannabis and cerebrovascular events. This accords well with epidemiological and mechanistic research on the cerebrovascular effects of cannabis.
METHODS: All case reports on cannabis and cerebrovascular events were retrieved. Four causality criteria were addressed: temporality, adequacy of stroke work-up, effects of rechallenge, and concomitant risk factors that could account for the cerebrovascular event.
RESULTS: There were 34 case reports on 64 patients. Most cases (81%) exhibited a temporal relationship between cannabis exposure and the index event. In 70%, the evaluation was sufficiently comprehensive to exclude other sources for stroke. About a quarter (22%) of patients had another stroke after subsequent re-exposure to cannabis. Finally, half of patients (50%) had concomitant stroke risk factors, most commonly tobacco (34%) and alcohol (11%) consumption.
CONCLUSIONS: Many case reports support a causal link between cannabis and cerebrovascular events. This accords well with epidemiological and mechanistic research on the cerebrovascular effects of cannabis.
Affiliation :
Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada