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Delayed Cerebral Ischemia Increased for Cannabis Users With aSAH

Independent association seen for cannabis use with DCI in patients with aneurysmal subarachnoid hemorrhage

THURSDAY, Jan. 6, 2022 (HealthDay News) — Among patients with aneurysmal subarachnoid hemorrhage (aSAH), cannabis users are more likely to have delayed cerebral ischemia (DCI), according to a research letter published online Jan. 6 in Stroke.

Joshua S. Catapano, M.D., from St. Joseph’s Hospital and Medical Center in Phoenix, and colleagues examined the effects of cannabis on DCI and other outcomes among patients with aSAH. A total of 1,014 patients were hospitalized and treated for aSAH during the 12-year study; patients were screened for cannabis use, and for other vasoactive substances (cocaine, amphetamines, and tobacco).

The researchers found that the rates of DCI, poor functional outcome, and mortality were 36.2, 50.2, and 13.5 percent, respectively. Overall, 46 patients screened positive for cannabis (4.5 percent positivity rate). Patients with a urine drug screen positive for cannabis had a significantly higher rate of DCI (52.2 versus 35.4 percent). There were no associations for cocaine, methamphetamine, or tobacco use with DCI. Radiographic vasospasm occurred significantly more often in cannabis users than nonusers (88.9 versus 70.5 percent). In a propensity score-adjusted binary logistic regression analysis, there was an independent association observed for cannabis use with an increased likelihood of DCI (odds ratio, 2.7).

“When people come in with ruptured aneurysms, and they have a history of cannabis use or are positive on a toxicology screen, it should raise a red flag to the treating team that they are at higher risk of vasospasm and ischemic complication,” a coauthor said in a statement.

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