A Rare Pediatric Case of Marijuana-Induced Reversible Cerebral Vasoconstriction Syndrome

Bliss, Laura; McGowan, Bridget; Rahman, A

doi:10.1016/j.pediatrneurol.2021.03.008

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…Published case reports have been expertly summarized in a recent review [98]. Our search resulted in a few more reported cases [78,[99][100][101][102][103][104][105][106]. Compared to adults, male patients are more common in children, particularly adolescents, and RCVS occurs more commonly in the setting of some underlying diseases, such as hematologic disorders.…”

Section: Rcvs Headaches In Children Vs Adultsmentioning

confidence: 99%

Headache Attributed to Reversible Cerebral Vasoconstriction Syndrome (RCVS)

Tentolouris-Piperas,

Lymperopoulos,

Tountopoulou

et al. 2023

Diagnostics

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Reversible cerebral vasoconstriction syndrome (RCVS) is a condition with variable outcomes presenting a new onset thunderclap headache accompanied by focal neurological symptoms or seizures. It can be idiopathic or arise secondarily to a variety of trigger factors. The condition is increasingly recognized in clinical practice, but many facets remain poorly understood. This article aims to clarify the headache characteristics in RCVS, the temporal association of angiographic findings, the potential association of the condition with SARS-CoV-2 infection, and the clinical presentation of RCVS in children and is based on a systematic PRISMA search for published analytical or large descriptive observational studies. Data from 60 studies that fulfilled specific criteria were reviewed. Most people with RCVS exhibit a typical thunderclap, explosive, or pulsatile/throbbing headache, or a similar acute and severe headache that takes longer than 1 min to peak. Atypical presentations or absence of headaches are also reported and may be an underrecognized phenotype. In many cases, headaches may persist after resolution of RCVS. Focal deficits or seizures are attributed to associated complications including transient ischemic attacks, posterior reversible encephalopathy syndrome, ischemic stroke, cerebral edema, and intracranial hemorrhage. The peak of vasoconstriction occurs usually within two weeks after clinical onset, possibly following a pattern of centripetal propagation, and tends to resolve completely within 3 months, well after symptoms have subsided. There are a few reports of RCVS occurring in relation to SARS-CoV-2 infection, but potential underlying pathophysiologic mechanisms and etiological associations have not been confirmed. RCVS occurs in children most often in the context of an underlying disease. Overall, the available data in the literature are scattered, and large-scale prospective studies and international collaborations are needed to further characterize the clinical presentation of RCVS.

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Section: Rcvs Headaches In Children Vs Adultsmentioning

confidence: 99%

Headache Attributed to Reversible Cerebral Vasoconstriction Syndrome (RCVS)

Tentolouris-Piperas,

Lymperopoulos,

Tountopoulou

et al. 2023

Diagnostics

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Dissecting the role of cannabinoids in vascular health and disease

Guo,

Wei,

Pei

et al. 2024

Journal Cellular Physiology

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Cannabis, often recognized as the most widely used illegal psychoactive substance globally, has seen a shift in its legal status in several countries and regions for both recreational and medicinal uses. This change has brought to light new evidence linking cannabis consumption to various vascular conditions. Specifically, there is an association between cannabis use and atherosclerosis, along with conditions such as arteritis, reversible vasospasm, and incidents of aortic aneurysm or dissection. Recent research has started to reveal the mechanisms connecting cannabinoid compounds to atherosclerosis development. It is well known that the primary biological roles of cannabinoids operate through the activation of cannabinoid receptor types 1 and 2. Manipulation of the endocannabinoid system, either genetically or pharmacologically, is emerging as a promising approach to address metabolic dysfunctions related to obesity. Additionally, numerous studies have demonstrated the vasorelaxant properties and potential atheroprotective benefits of cannabinoids. In preclinical trials, cannabidiol is being explored as a treatment option for monocrotaline‐induced pulmonary arterial hypertension. Although existing literature suggests a direct role of cannabinoids in the pathogenesis of atherosclerosis, the correlation between cannabinoids and other vascular diseases was only reported in some case series or observational studies, and its role and precise mechanisms remain unclear. Therefore, it is necessary to summarize and update previously published studies. This review article aims to summarize the latest clinical and experimental research findings on the relationship between cannabis use and vascular diseases. It also seeks to shed light on the potential mechanisms underlying these associations, offering a comprehensive view of current knowledge in this evolving field of study.

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