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Published on: September 15, 2017
[Bilateral adrenal hemorrhage (BAH): cannabis and vascular involvement]
Insights
Long-term daily cannabis use may be linked to vascular pathologies, including bilateral adrenal hemorrhage and stroke. This case highlights the need for vigilance regarding cannabis-related health risks in clinical settings.
Area of Science:
- Vascular Medicine
- Neurology
- Endocrinology
Background:
- Cannabis is the most widely consumed recreational drug globally.
- Increasing frequency of serious non-psychiatric complications associated with cannabis use.
- Observed complications include neurological, cerebrovascular, cardiovascular, and respiratory issues.
Observation:
- A 39-year-old man presented with bilateral adrenal hemorrhage.
- The patient had a history of stroke six years prior to this event.
- Diagnosis of adrenal hemorrhage is rarely made by imaging alone.
Findings:
- A probable link between long-term daily cannabis use and the patient's vascular pathologies (adrenal hemorrhage and stroke) is suggested.
- Literature review supports a probable association between cannabis use and cerebrovascular events.
- Cannabis use is increasingly associated with severe medical complications.
Implications:
- Clinicians should maintain vigilance for potential cannabis-related complications in hospitalized patients.
- Thorough patient history, including substance use, is crucial for diagnosis and management.
- Optimized screening and adapted treatment strategies are necessary for patients with cannabis use disorder and associated comorbidities.
Abstract:
We report the case of a 39-year-old man with bilateral adrenal haemorrhage. The diagnosis is rarely primarily made with imaging alone. Our patient had a previous history of a stroke six years prior to this episode. We evoke the possibility that long-term daily cannabis use could be the underlying cause of the patient's vascular pathologies. After thorough review of existing literature, this link was found to be probable. Cannabis is the most consumed recreational drug in the world, and this tendency is ever-increasing. Serious complications other than psychiatric resulting from consumption are reported with increasing frequency. Neurological, cerebrovascular, cardiovascular and respiratory complications have been observed. It is thus important to remain vigilant when patients are hospitalised notably through the emergency department, in order to obtain a complete anamnesis, optimise screening, and to adapt the treatment of these patients.
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