Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Apr 7;21(6):25.
doi: 10.1007/s11910-021-01113-2.

Cerebrovascular Complications Associated with Marijuana Use

Bayan Moustafa  1 , Fernando D Testai  2
Affiliations
Review

Cerebrovascular Complications Associated with Marijuana Use

Bayan Moustafa et al. Curr Neurol Neurosci Rep. .

Abstract

Purpose of review: In the last few years, the attitude toward marijuana in many parts of the world has shifted from illicit to legalized for medical use and to decriminalized. In parallel, there has been a gradual increase in the consumption of this product in the general population, particularly among adolescents and young adults. Marijuana is generally perceived as a harmless drug. However, data obtained in observational studies and preclinical models have established associations between cannabis use and cardiovascular events. In addition, there is emerging evidence linking marijuana use to cerebrovascular complications. Here we provide a critical review of the literature with special emphasis on the association of cannabinoids with stroke and the possible pathogenic mechanisms involved.

Recent findings: Ischemic and hemorrhagic stroke have been described in association with cannabis use, particularly in young individuals. Cerebral infarction remains the most commonly reported stroke subtype seen in marijuana users. Several pathogenic mechanisms have been proposed to explain this association, including multifocal intracranial stenosis, reversible cerebral vasoconstriction syndrome, and coexisting vascular risk factors. Cannabis use is increasingly recognized in young individuals presenting with acute stroke. Our understanding of the pathogenic mechanisms associated with cannabis use and stroke is limited but rapidly evolving. Healthcare providers should educate patients about the potential cardiovascular and cerebrovascular complications related to marijuana or cannabinoids use.

Keywords: Cannabinoids; Endocannabinoid system; Intracerebral hemorrhage; Ischemic stroke; RCVS; Δ-9-Tetrahydocannabinol.

PubMed Disclaimer

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Melis M, Pistis M, Perra S, Muntoni AL, Pillolla G, Gessa GL. Endocannabinoids mediate presynaptic inhibition of glutamatergic transmission in rat ventral tegmental area dopamine neurons through activation of CB1 receptors. J Neurosci. 2004;24(1):53–62. https://doi.org/10.1523/JNEUROSCI.4503-03.2004 . - DOI - PubMed - PMC
    1. Wise RA. Roles for nigrostriatal--not just mesocorticolimbic--dopamine in reward and addiction. Trends Neurosci. 2009;32(10):517–24. https://doi.org/10.1016/j.tins.2009.06.004 . - DOI - PubMed - PMC
    1. Munro S, Thomas KL, Abu-Shaar M. Molecular characterization of a peripheral receptor for cannabinoids. Nature. 1993;365(6441):61–5. https://doi.org/10.1038/365061a0 . - DOI - PubMed - PMC
    1. Devane WA, Hanus L, Breuer A, Pertwee R, Stevenson L, Griffin G, et al. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. 1992;258(5090):1946–9. https://doi.org/10.1126/science.1470919 . - DOI - PubMed - PMC
    1. Puhl S. Cannabinoid-sensitive receptors in cardiac physiology and ischaemia. Biochim Biophys Acta. 1867;2020:118462.

LinkOut - more resources