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Letters   |    
Recurrent Stroke in a Young Cannabis User
Ana Filipa Santos, M.D.; Margarida Rodrigues, M.D.; Ricardo Maré, M.D.; Carla Ferreira, M.D.; João Soares-Fernandes, M.D.; Jaime Rocha, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E41-E42. doi:10.1176/appi.neuropsych.13020037
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Disclosure: the authors do not have any conflict of interest.

Neurology Department, Hospital de Braga, Braga, Portugal

Neuroradiology Department, Hospital de Braga, Braga, Portugal

Correspondence: Dr. Santos; e-mail: filipasantos@hotmail.com

Copyright © 2014 by the American Psychiatric Association

Extract

Dear Sir: Drug misuse is a known risk factor for cerebrovascular disease, especially among young people.1,2 Cannabis is the most widely-consumed illicit drug worldwide, but it has only occasionally been associated with ischemic vascular events.13 Vasospasm, hypotension, arrhythmias, and vasculitis have been proposed as potential mechanisms.14 We report on a case of recurrent stroke in a young cannabis user.

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FIGURE 1. [A]: Axial diffusion-weighted imaging shows right frontal and parietal cortical and subcortical acute ischemic lesions, corresponding to the anterior cerebral artery (ACA) and middle cerebral artery (MCA) regions; [B]: Axial T2-weighted image demonstrates old vascular lesions in the basal ganglia bilaterally; [C]: MR angiography, 3D-TOF imaging, reveals proximal occlusion of the left MCA and distal occlusion of the right M1 MCA segment. Diffuse ectasia and irregularities of both carotids, left ACA and right M-1 segment, are seen. Increased visualization of external carotid branches suggests collateralization.
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References

Singh  NN;  Pan  Y;  Muengtaweeponsa  S  et al:  Cannabis-related stroke: case series and review of literature.  J Stroke Cerebrovasc Dis 2012; 21:555–560
[CrossRef] | [PubMed]
 
Mateo  I;  Pinedo  A;  Gomez-Beldarrain  M  et al:  Recurrent stroke associated with cannabis use.  J Neurol Neurosurg Psychiatry 2005; 76:435–437
[CrossRef] | [PubMed]
 
Wolff  V;  Armspach  JP;  Lauer  V  et al:  Cannabis-related stroke: myth or reality? Stroke 2013; 44:558–563
[CrossRef] | [PubMed]
 
Geibprasert  S;  Gallucci  M;  Krings  T:  Addictive illegal drugs: structural neuroimaging.  AJNR Am J Neuroradiol 2010; 31:803–808
[CrossRef] | [PubMed]
 
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