Abstract WP271: Marijuana Use and Stroke: A Systematic Review and Meta-Analysis

Abstract

Introduction: The prevalence of stroke among young adults has been on the rise, along with a similar rising trend in marijuana use. Ischemic strokes, intracerebral hemorrhage (ICH), reversible cerebral vasoconstriction syndrome (RCVS), and subarachnoid hemorrhage (SAH) are among the commonly reported neurovascular events associated with marijuana use. We attempted to systematically review the literature and find an association between marijuana use and stroke. Methods: We searched data from PubMed/Medline, SCOPUS and studies that met the inclusion criteria were selected and Review Manager 5.4.1 was used for statistical analysis of data. Twenty six studies with a total of 13,550 patients were selected of which 11 were included in the meta analysis. Results: The pooled odds of cannabis use in ischemic stroke patients was statistically significant at 1.16 (95% CI: 1.07-1.25). Among patients with undefined stroke, pooled odds of cannabis use were 0.86 (0.43, 1.72). Meta-analysis for the SAH subgroup could not be done due to varying outcome measures. Overall, upon combining all the subgroups, the odds of cannabis use among stroke patients was not significant (OR: 0.96; 0.77,1.20, I2-100%). High heterogeneity might be the pooling of studies with different stroke types and individual study variations. Conclusions: Cannabis use was significantly associated with ischemic stroke although this significance was not maintained among other stroke subgroups and with overall analysis. Further research should be done to assess the association of dose, chronicity and frequency of cannabis on stroke to further delineate the true association.