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Unknown Tetrahydrocannabinol Edible Ingestion Resulting in Acute Stroke Presentation

      We appreciate the Letter to the Editor written by Drs. Desai and Parekh in regard to our previously published article, and we agree that both physicians and cannabis users should be aware of the possibility that use may potentiate the risk of stroke, including in younger-aged individuals. We also agree that prospectively collected data to better objectively evaluate this risk is crucial as the market for cannabis continues to grow. Elderly individuals have increased access to cannabis, and use in this population has also increased in recent years, similar to other age groups (
      • Han B.H.
      • Palamar J.J.
      Trends in cannabis use among older adults in the United States, 2015–2018.
      ). The risk of stroke and other neurovascular disease processes in elderly cannabis consumers who already have comorbid conditions that put them at increased risk for these adverse events should be more closely studied. We hope that our case study, in addition to the work conducted by our colleagues, illustrates the importance of continued research characterizing the risk of stroke and other neurovascular conditions related to the use of cannabis.
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      Reference

        • Han B.H.
        • Palamar J.J.
        Trends in cannabis use among older adults in the United States, 2015–2018.
        JAMA Intern Med. 2020; 180: 609-611

      Linked Article

      • Cannabis-Associated Stroke Presentations: No Smoke Without a Fire
        Journal of Emergency MedicineVol. 59Issue 4
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          We read with great interest the first-ever case reported by Dr. Finch and Dr. Vilke regarding the tetrahydrocannabinol (THC) edible ingestion resulting in an acute stroke (1). We agree that this is a unique case of focal neurological deficits occurring in the setting of THC ingestion, and also, it is hard to deliberate that intoxication timing and an episode of transient ischemic attack was just an accidental co-occurrence. Interestingly, in our prior studies using nationally representative cohorts of cannabis users, we observed a positive association between cannabis use and the rising frequency of stroke admissions in the United States (2–5).
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