Investig Magn Reson Imaging.  2018 Sep;22(3):168-171. 10.13104/imri.2018.22.3.168.

Ischemic Stroke after Use of Cannabis: a Case Report and Review of Literature

• Jung JS
• Park YW
• Lee SA
• Song TJ
• Lim SM

• KMID: 2421548
• DOI: http://doi.org/10.13104/imri.2018.22.3.168

Abstract

Cannabis or marijuana is the most commonly used recreational drug after alcohol in the world, and usage is generally recognized as having few serious adverse effects. However, usage is restricted in South Korea. The report of ischemic stroke associated with cannabis is rare in literature. We present a case of a 47-year-old female patient with no underlying disease presenting with acute ischemic stroke after smoking cannabis in South Korea. The result for synthetic cannabinoid metabolites (delta-9 tetrahydrocannabinol) screening was positive. Absence of other vascular risk factors and drug screening results suggest a causal role of cannabis in this ischemic stroke case. The patient eventually progressed to brain death. The underlying mechanism, clinical manifestation, and imaging findings of cannabis-related stroke will be reviewed.

Keyword

Cannabis; Marijuana; Ischemic stroke

MeSH Terms

Brain Death
Cannabis*
Drug Evaluation, Preclinical
Female
Humans
Korea
Mass Screening
Middle Aged
Risk Factors
Smoke
Smoking
Stroke*
Smoke

Figure

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  Fig. 1 Diffusion-weighted images (a, d), apparent diffusion coefficient maps (b, e), and fluid attenuated inversion recovery images (c, f) revealing acute infarctions at the right parietooccipital lobe, basal ganglia, and thalamus.

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  Fig. 2 Time-of-flight magnetic resonance angiography (a, b) revealing multifocal moderate to severe stenosis at intracranial arteries; including the right distal ICA, right M1, right A1, distal basilar artery, right PCA, and left PCA.

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