Pot Use Raises Risks After Severe Form of Stroke

Friday, January 7, 2022 — If you have any risk factors for stroke and would like to smoke pot, a new study suggests you should stop writing.

Researchers found that people with aneurysms with subarachnoid hemorrhage, a rare and severe type of hemorrhagic stroke, who used marijuana three to 30 days before their stroke were more likely to develop serious complications that could lead to increased disability or death.

It was the largest study that looked at the effect of THC, the ingredient in marijuana that makes a person high, on complications after this type of stroke.

The study’s senior author, Dr. Michael Lawton, president and CEO of the Barrow Neurological Institute in Phoenix.

His team analyzed data on more than 1,000 patients treated for subarachnoid hemorrhage and aneurysms at the institute between January 1, 2007 and July 31, 2019.

All patients were treated to stop the bleeding in one of two ways: by inserting a thin tube through a blood vessel to the base of the aneurysm and releasing coils that provide a barrier to further bleeding; Or by complete surgery to cut the base of the aneurysm.

A urine toxicology examination was performed for all admitted patients with a ruptured aneurysm.

In a subarachnoid hemorrhage, a weak, swollen portion of the blood vessel on the surface of the brain ruptures. This is called a ruptured aneurysm. It results in bleeding into the space between the brain and the tissues that cover it and can cause neurological disability in 66% of people and death in 40%.

Immediate treatment focuses on stopping and preventing further bleeding. However, within 14 days after this type of stroke, patients may have worsening symptoms, such as speech problems or difficulty moving.

This complication, called delayed cerebral ischemia, occurs when the blood from the initial stroke irritates the blood vessels, causing them to constrict enough to cut off the blood supply to a part of the brain (called a vasospasm).

The study compared the incidence of delayed cerebral ischemia in 46 people who tested positive for THC and 968 people who tested negative for THC.

Recent cannabis users did not have significantly more aneurysms or worse stroke symptoms when they were hospitalized. Nor were they more likely to have high blood pressure or other cardiovascular risk factors than patients who tested negative for THC. They were significantly more likely to also test positive for other substances, including cocaine, methamphetamine and tobacco, compared to patients who tested negative for THC.

Of all participants, 36% developed delayed cerebral ischemia, 50% developed moderate to severe disability, and 13.5% died.

The researchers found that those who tested positive for THC were 2.7 times more likely to develop delayed cerebral ischemia, 2.8 times more likely to develop moderate to severe long-term physical disability and 2.2 times more likely to die.

The results were published January 6 in the journal brain attack.

“When people come in with a ruptured aneurysm, have a history of cannabis use or are positive on a toxicology screen, it should raise a red flag for the treating team that they are at increased risk of vasospasm and ischemic complications,” Lawton said. In a press release in the magazine.

“Of all the substances detected in the toxicology examination, only cannabis increased the risk of late cerebral ischemia,” he said. “Cocaine and methamphetamine are antihypertensive drugs, so they are likely to be related to actual rupture but are not expected to have an effect on vasospasm.”

The researchers are now conducting follow-up in the laboratory to understand the risks associated with THC, which may affect the formation and rupture of aneurysms. They also urge more research to study the effect of different doses of THC on stroke complications.

“Evaluating the risks and benefits of marijuana use is more important, given its popularity and as more states make recreational marijuana use legal,” Lawton said.

Resources

  • brain attack, press release, 6 January 2022

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