Cannabis Use and Stroke: Does a Risk Exist?. Issue 2 (17th March 2022)

• Record Type: Journal Article
• Authors: Swetlik, Carol; Migdady, Ibrahim; Hasan, Leen Z.; Buletko, Andrew Blake; Price, Carrie; Cho, Sung-Min
• Is Part Of: Journal of addiction medicine. Volume 16:Issue 2(2022)
• Page Start: 208
• Page End: 215
• Publication Date: 2022-03-17
• Subjects: cannabis -- intracranial hemorrhage -- ischemic stroke -- tetrhydrocannbinol; Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86005
• DOI: 10.1097/ADM.0000000000000870
• Languages: English
• ISSNs: 1932-0620

Abstract

Abstract : Aims: Cannabis use has been reported as a risk factor for stroke. We systematically review the prevalence and outcomes of stroke in people with cannabis use. Methods: We searched MEDLINE and 6 other databases from inception to January 2020 for studies on the relationship between cannabis use and stroke. We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Two independent reviewers extracted the data. Study quality was assessed by the Newcastle-Ottawa Scale for cohort and case-control studies. Results: Seventeen studies involving 3, 185, 560 people with cannabis use were included. Descriptive statistics demonstrated 18, 676 (median 1.1%, interquartile range [IQR] 0.3%–1.3%) experienced stroke compared with 0.8% of those without use (Odds Ratio 1.17, 95% CI 1.10–1.25). Among people with cannabis use, median age was 26.2 years (IQR 25.2–34.3 years) and mostly male (median 57.8%). Of stroke subtypes, ischemic stroke was most prevalent (median 1.2%, IQR 0.4%–1.9%), followed by undefined stroke subtype (median 1.2%, IQR 1.1%–1.2%) and hemorrhagic stroke (median 0.3%, IQR 0.1%–0.6%). The majority of people with cannabis use who experienced stroke survived (median: 85.1%, IQR 83%–87.5%) and 64.0% of people experienced a good neurologic outcome, defined as modified Rankin Scale of 0 to 3. Few studies included outcomes of vasospasm or seizure. Conclusions: In people with cannabis use, the prevalence of ischemic stroke and hemorrhagic stroke was 1.2% and 0.3%, respectively, higher than the prevalence of people without use (0.8% and 0.2%). There is insufficient information on timing, exposure, duration, and dose-responsive relationship.