To determine the effect of cannabis use on the acute functional outcomes in young adults hospitalized with acute ischemic stroke. 

Cannabis use remains controversial as a risk factor for stroke while containing constituents with purported neuroprotective properties. To date, there are no studies that examine the effect of cannabis use on ischemic stroke recovery.  

We performed a retrospective cohort analysis of 521 patients admitted to the University of Colorado, ages 18-65, with a diagnosis of acute ischemic stroke and social history either positive or negative for cannabis use. 

The modified Rankin scale(MRS) was dichotomized as ≤1 for good functional outcome, or >1.  Discharge disposition was dichotomized to home or to a facility.

The good functional outcomes and discharge home were analyzed with logistic regression.  Length of stay was analyzed with a Cox proportional hazards model.  Each model controlled for National Institute of Health stroke score (NIHSS), age, sex, race, ethnicity, insurance payer (public vs. commercial), and average income by ZIP code.

For poorer functional outcomes (MRS >1), a history of cannabis use resulted in an odds ratio of 1.1160 (95% confidence interval 0.58- 2.14, p-value=0.74). For discharge to facility, cannabis use had an odds ratio of 0.85 (95% confidence interval 0.43-1.67), p-value=0.63).  For length of stay, cannabis use had a hazard ratio of 0.79 (95% confidence interval 0.58-1.08, p value = 0.14). 

In young adults admitted with acute ischemic stroke, cannabis use did not significantly associate with worse outcomes (either by MRS, length or stay, or discharge disposition). The study is limited by lack of a laboratory measure of cannabis use on admission and potentially insufficient power to detect a significant difference in outcomes.