title: Cannabis Use and Outcomes in Patients With Aneurysmal Subarachnoid Hemorrhage.
abstract: The incidence of cannabis use in patients with aneurysmal subarachnoid hemorrhage (aSAH) and its impact on morbidity, mortality, and outcomes are unknown. Our objective was to evaluate the relationship between cannabis use and outcomes in patients with aSAH.
  
  
  
  Records of consecutive patients admitted with aSAH between 2010 and 2015 were reviewed. Clinical features and outcomes of aSAH patients with negative urine drug screen and cannabinoids-positive (CB+) were compared. Regression analyses were used to assess for associations.
  
  
  
  The study group consisted of 108 patients; 25.9% with CB+. Delayed cerebral ischemia was diagnosed in 50% of CB+ and 23.8% of urine drug screen negative patients (P=0.01). CB+ was independently associated with development of delayed cerebral ischemia (odds ratio, 2.68; 95% confidence interval, 1.03-6.99; P=0.01). A significantly higher number of CB+ than urine drug screen negative patients had poor outcome (35.7% versus 13.8%; P=0.01). In univariate analysis, CB+ was associated with the composite end point of hospital mortality/severe disability (odds ratio, 2.93; 95% confidence interval, 1.07-8.01; P=0.04). However, after adjusting for other predictors, this effect was no longer significant.
  
  
  
  We offer preliminary data that CB+ is independently associated with delayed cerebral ischemia and possibly poor outcome in patients with aSAH. Our findings add to the growing evidence on the association of cannabis with cerebrovascular risk.
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio. Behrouz@uthscsa.edu.
authors.forename: Réza
authors.initials: R
authors.lastname: Behrouz
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Lee
authors.initials: L
authors.lastname: Birnbaum
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Grandhi
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Johnson
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Vivek
authors.initials: V
authors.lastname: Misra
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Santiago
authors.initials: S
authors.lastname: Palacio
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Ali
authors.initials: A
authors.lastname: Seifi
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Christopher
authors.initials: C
authors.lastname: Topel
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Rachel
authors.initials: R
authors.lastname: Garvin
authors.affiliation: From the Departments of Neurology (R.B., L.B., V.M., S.P., C.T.), Neurosurgery (L.B., R. Grandhi, J.J., A.S., R.G., R. Garvin, J.-L.C.), School of Medicine, University of Texas Health Science Center, San Antonio.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Caron
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000139:chemically induced / Q000209:etiology*; D002186:Cannabinoids / Q000009:adverse effects* / Q000652:urine; D002188:Cannabis / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000209:etiology
chemical_list: D002186:Cannabinoids
keywords: cannabis; ischemia; marijuana; subarachnoid hemorrhage