Shere Amar, Goyal Hemant
Medical Center Navicent Health, 790 1st Street, Macon, GA 31201, United States.
Mercer University School of Medicine, 707, Pine St, Macon, GA 31201, United States.
Am J Emerg Med. 2017 Dec;35(12):1988.e1-1988.e2. doi: 10.1016/j.ajem.2017.09.049. Epub 2017 Sep 28.
Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke. However, hemorrhagic strokes, which are often seen with sympathomimetic illicit drugs (e.g. cocaine and amphetamines), have rarely been reported due to cannabis. Many cellular mechanisms within non-ischemic tissue post stroke may be augmented by heavy cannabis use. Here, we describe a rapid development of hemorrhage following thrombolytic therapy in a patient with heavy cannabis use with an ischemic stroke.
大麻是美国最常用的非法药物之一，被认为会对健康产生多种不良影响。有证据表明，其娱乐性使用与心血管和脑血管事件增加均有关联。最近，文献中报道了多例与使用大麻相关的缺血性和出血性中风病例（戈亚尔等人，2017年）。有人提出，大麻会影响大脑的自动调节和血管张力，导致血管收缩和急性缺血性中风。然而，出血性中风通常与拟交感神经非法药物（如可卡因和安非他明）有关，因大麻导致的出血性中风很少有报道。中风后非缺血组织内的许多细胞机制可能会因大量使用大麻而增强。在此，我们描述了一名大量使用大麻且患有缺血性中风的患者在溶栓治疗后迅速发生出血的情况。
