Cerebellar Infarction in Adolescent Males Associated With Acute Marijuana Use

Author:

Geller Thomas12,Loftis Laura2,Brink David S.3

Affiliation:

1. Neurology

2. Pediatrics

3. Pathology, St Louis University School of Medicine, St Louis, Missouri

Abstract

Objective. To demonstrate the clinical characteristics, radiologic findings, and neuropathological features of tetrahydrocannabinol-related posterior fossa ischemic stroke in adolescent patients. Design. A retrospective case and chart review of 3 cases encountered at a tertiary care institution over a span of 5 years. Setting. Inpatient and intensive care hospitalization units managing children and adolescents. Subjects. Male adolescent patients with ischemic cerebellar stroke after use of marijuana. Diagnostic Investigations. Computed tomography brain scans (3 subjects), magnetic resonance imaging brain study (1 subject), cerebral arteriography (1 subject), cerebellar biopsy (1 subject), and necropsy (2 subjects). Results. Three adolescent males had similar presentations of headache, fluctuating level of consciousness or lethargy, visual disturbance, and variable ataxia after self-administration of marijuana. They developed primary cerebellar infarctions within days after the exposure that could not be attributed to supratentorial herniation syndromes and only minimally involved brainstem structures. Conclusions. Episodic marijuana use may represent a risk factor for stroke in childhood, particularly in the posterior circulation. Early recognition of the cerebellar stroke syndrome may allow prompt neurosurgical intervention, reducing morbidity.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference25 articles.

1. De Veber, Roach ES, Riela AR, Wiznitzer M. Stroke in children: recognition, treatment, and future directions. Semin Pediatr Neurol.2000;7:309–317

2. Pavlakis SG, Gould RJ, Zito JL. Stroke in children. Adv Pediatr.1991;38:151–179

3. Garcia JH, Anderson ML. Circulatory disorders and their effects on the brain. In: Davis RL, Robertson DM, eds. Textbook of Neuropathology. Second ed. Baltimore, MD: Williams & Wilkins; 1991:621–718

4. Brink D, Manepalli A, Geller T, Vogler C. Cerebellar infarction associated with marijuana use in adolescent children. Mod Pathol.2001;14:5P

5. White D, Martin D, Geller T, Pittman T. Stroke associated with marijuana abuse. Pediatr Neurosurg.2000;32:92–94

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