|Titre :||Cannabis and stroke: systematic appraisal of case reports (2015)|
|Auteurs :||D. G. HACKAM|
|Type de document :||Article : Périodique|
|Dans :||Stroke (Vol.46, n°3, March 2015)|
|Article en page(s) :||852-856|
|Discipline :||PAT (Pathologie organique / Organic pathology)|
Thésaurus TOXIBASEETUDE DE CAS ; CANNABIS ; CERVEAU ; APPAREIL CARDIOVASCULAIRE ; PATHOLOGIE ORGANIQUE ; FACTEUR DE RISQUE ; INFARCTUS
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.
|Domaine :||Drogues illicites / Illicit drugs|
|Sous-type de document :||Revue de la littérature / Literature review|
|Refs biblio. :||39|
Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada