Cerebral Infarction Associated with Marijuana

ABSTRACT

Whereas stroke that is associated with the use of various street drugs has been frequently noted, cerebral infarction related to marijuana has been rarely reported. We experienced a 36 year-old male who developed sudden onset of dizziness and gait disturbance after marijuana smoking. On admission, neurological examination revealed right cerebellar dysfunction with prominent falling tendency to right side during tandem gait. Brain MRI showed high signal intensity on T2-weighted image on right posterior inferior cerebellar arterial (PICA) territory suggesting acute infarction. He had no risk factors for stroke except tobacco smoking and denied the use of other street drugs. Serologic work-up for coagulopathy and cardiologic evaluation were unremarkable. On cerebral angiogram, narrowing of proximal part of left PICA and diffusely spastic arterial changes of whole posterior circulation were revealed. On the basis of the physiologic effect of marijuana, we could infer that the probable mechanism of the stroke was intracerebral vasoconstriction or hemodymic change.