Marijuana induced Reversible Cerebral Vasoconstriction Syndrome

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS)
is a transient multifocal arterial vasoconstriction and
dilatation. The term was proposed by a panel of experts1
as a unifying term for a variety of a syndromes characterized by cerebral vasospasms and resultant clinical
manifestations of cerebral ischemia. These syndromes
include Call–Fleming syndrome, drug-induced cerebral
angiopathy, benign angiopathy of the CNS, postpartum
cerebral angiopathy, and migrainous vasospasm. Drug
abuse, especially cannabis, is an important etiologic factor for RCVS. It is one of the most widely used recreational substances in the world, considered by many consumers as a relatively safe drug with few significant
side-effects.2
Cannabis contains 9-tetrahydrocannabinol
(THC), which is rapidly absorbed when smoked, reaching a peak plasma concentration at 10–30 min, and is
lipid soluble with a large volume of distribution.3 Cannabinoids bind to cannabinoid receptors, CB1 in the
central nervous system and CB2 in the immune system.