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Original Paper

Prior Cannabis Use Is Associated with Outcome after Intracerebral Hemorrhage

Di Napoli M.a, b · Zha A.M.c · Godoy D.A.d, e · Masotti L.f · Schreuder F.H.B.M.g · Popa-Wagner A.h, i · Behrouz R.j · from the MNEMONICH Registry

Author affiliations

aNeurological Service, San Camillo de' Lellis General Hospital, Rieti, bNeurological Section, SMDN - Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy; cDepartment of Neurology, Ohio State University College of Medicine, Columbus, Ohio, USA; dThe Neurointensive Care Unit, Sanatorio Pasteur and eIntensive Care Unit, Hospital Interzonal de Agudos ‘San Juan Bautista', Catamarca, Argentina; fDepartment of Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy; gDepartment of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; hDepartment of Psychiatry, Rostock University Medical School, Rostock, Germany; iUniversity of Medicine and Pharmacy, Craiova, Romania; jDepartment of Neurology, School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, Tex., USA

Related Articles for ""

Cerebrovasc Dis 2016;41:248-255

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 18, 2015
Accepted: December 21, 2015
Published online: January 29, 2016
Issue release date: April 2016

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED

Abstract

Objective: Recent evidence suggests that a potential harmful relationship exists between cannabis use and ischemic stroke. The purpose of this study was to determine the implications of cannabis use in intracerebral hemorrhage (ICH) patients. Methods: An analysis of an international, multicenter, observational database of consecutive patients with spontaneous ICH was conducted. We extracted the following characteristics on presentation: demographics, risk factors, antiplatelet or anticoagulant use, Glasgow Coma Scale, ICH score, neuroimaging parameters, and urine toxicology screen (UTS) results. Modified Rankin Scale (mRS) score was utilized for determination of outcome at discharge. Adjusted logistic ordinal regression was used as shift analysis to assess the impact of cannabis use on mRS score at discharge. The adjusted common OR measured the likelihood that cannabis use would lead to lower mRS scores. Results: Within a cohort of 725 spontaneous ICH patients, UTS was positive for cannabinoids in 8.6%. Cannabinoids-positive (CB+) patients were more frequently Caucasian (p < 0.001), younger (p < 0.001), and had lower median ICH scores on admission (p = 0.017) than those who were cannabinoids-negative. CB+ patients also showed a shift toward better outcome in the distribution of mRS categories, with an adjusted common OR of 0.544 (95% CI 0.330-0.895, p = 0.017). Conclusion: In this multinational cohort, cannabis use was discovered in nearly 10% of patients with spontaneous ICH. Although there was no relationship between cannabis use and specific ICH characteristics, CB+ patients had milder ICH presentation and less disability at discharge.

© 2016 S. Karger AG, Basel


References

  1. Prevalence of Drug Use among the General Population. World Drug Report 2012. United Nations Office on Drugs and Crime. http://www.unodc.org/unodc/en/data-and-analysis/WDR-2012.html (accessed March 9, 2015).
  2. Wolff V, Armspach JP, Lauer V, et al: Cannabis-related stroke: myth or reality? Stroke 2013;44:558-563.
  3. Behrouz R, Azarpazhooh MR, Godoy DA, et al; MNEMONICH Steering Committee: The multi-national survey on epidemiology, morbidity, and outcomes in intracerebral haemorrhage (MNEMONICH). Int J Stroke 2015;10:e86.
  4. Hemphill JC 3rd, Bonovich DC, Besmertis L, et al: The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke 2001;32:891-897.
  5. Kothari RU, Brott T, Broderick JP, et al: The ABCs of measuring intracerebral hemorrhage volumes. Stroke 1996;27:1304-1305.
  6. Morgenstern LB, Hemphill JC 3rd, Anderson C, Becker K, et al: Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2010;41:2108-2129.
  7. Steiner T, Kaste M, Forsting M, et al: Recommendations for the management of intracranial haemorrhage - part I: spontaneous intracerebral haemorrhage. The European Stroke Initiative Writing Committee and the Writing Committee for the EUSI Executive Committee. Cerebrovasc Dis 2006;22:294-316.
  8. van Swieten JC, Koudstaal PJ, Visser MC, et al: Interobserver agreement for the assessment of handicap in stroke patients. Stroke 1988;19:604-607.
  9. Bath PM, Lees KR, Schellinger PD, et al; European Stroke Organisation Outcomes Working Group: Statistical analysis of the primary outcome in acute stroke trials. Stroke 2012;43:1171-1178.
  10. Saver JL: Novel end point analytic techniques and interpreting shifts across the entire range of outcome scales in acute stroke trials. Stroke 2007;38:3055-3062.
  11. Degenhardt L, Chiu WT, Sampson N, et al: Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO world mental health surveys. PLoS Med 2008;5:e141.
  12. Camacho EJ, LoPresti MA, Bruce S, et al: The role of age in intracerebral hemorrhage: an intricate relationship. Austin J Cerebrovasc Dis Stroke 2014;1:1022.
  13. England TJ, Hind WH, Rasid NA, O'Sullivan SE: Cannabinoids in experimental stroke: a systematic review and meta-analysis. J Cereb Blood Flow Metab 2015;35:348-358.
  14. Hampson AJ, Grimaldi M, Lolic M, et al: Neuroprotective antioxidants from marijuana. Ann N Y Acad Sci 2000;899:274-282.
  15. Esposito G, Scuderi C, Savani C, et al: Cannabidiol in vivo blunts beta-amyloid induced neuroinflammation by suppressing IL-1beta and iNOS expression. Br J Pharmacol 2007;151:1272-1279.
  16. Carrier EJ, Auchampach JA, Hillard CJ: Inhibition of an equilibrative nucleoside transporter by cannabidiol: a mechanism of cannabinoid immunosuppression. Proc Natl Acad Sci U S A 2006;103:7895-7900.
  17. Blázquez C, Chiarlone A, Bellocchio L, et al: The CB1 cannabinoid receptor signals striatal neuroprotection via a PI3K/Akt/mTORC1/BDNF pathway. Cell Death Differ 2015;22:1618-1629.
  18. Keep RF, Hua Y, Xi G: Intracerebral haemorrhage: mechanisms of injury and therapeutic targets. Lancet Neurol 2012;11:720-731.
  19. Guan J, Zhang B, Zhang J, et al: Nerve regeneration and functional recovery by collagen-binding brain-derived neurotrophic factor in an intracerebral hemorrhage model. Tissue Eng Part A 2015;21:62-74.
  20. Cortese GP, Barrientos RM, Maier SF, Patterson SL: Aging and a peripheral immune challenge interact to reduce mature brain-derived neurotrophic factor and activation of TrkB, PLCgamma 1, and ERK in hippocampal synaptoneurosomes. J Neurosci 2011;31:4274-4279.
  21. Hind WH, Tufarelli C, Neophytou M, et al: Endocannabinoids modulate human blood-brain barrier permeability in vitro. Br J Pharmacol 2015;172:3015-3027.
  22. Capettini LS, Savergnini SQ, da Silva RF, et al: Update on the role of cannabinoid receptors after ischemic stroke. Mediators Inflamm 2012;2012:824093.
  23. Alshaarawy O, Anthony JC: Cannabis smoking and serum C-reactive protein: a quantile regressions approach based on NHANES 2005-2010. Drug Alcohol Depend 2015;147:203-207.
  24. Di Napoli M, Godoy DA, Campi V, et al: C-reactive protein level measurement improves mortality prediction when added to the spontaneous intracerebral hemorrhage score. Stroke 2011;42:1230-1236.
  25. Di Napoli M, Godoy DA, Campi V, et al: C-reactive protein in intracerebral hemorrhage: time course, tissue localization, and prognosis. Neurology 2012;79:690-699.
  26. Nguyen BM, Kim D, Bricker S, et al: Effect of marijuana use on outcomes in traumatic brain injury. Am Surg 2014;80:979-983.
  27. Brahm NC, Yeager LL, Fox MD, et al: Commonly prescribed medications and potential false-positive urine drug screens. Am J Health Syst Pharm 2010;67:1344-1350.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 18, 2015
Accepted: December 21, 2015
Published online: January 29, 2016
Issue release date: April 2016

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 1015-9770 (Print)
eISSN: 1421-9786 (Online)

For additional information: https://www.karger.com/CED


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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