Case report
Cannabis-associated Spontaneous Bilateral Basal Ganglia Haemorrhage: A Case Report
OD28-OD30
Correspondence
Rashmi Mishra,
19/804, 8th Floor, East End Apartments, Mayur Vihar Phase 1 Extension, New Delhi, India.
E-mail: rashmi.virgo02@gmail.com
Spontaneous Bilateral Basal Ganglia Haemorrhage (SBBGH) is an exceptionally rare entity, with fewer than sixty cases reported worldwide. Although cannabis use is a recognised risk factor for ischemic stroke, its association with Intracerebral Haemorrhage (ICH) remains uncommon and poorly characterised. A 23-year-old male with no vascular risk factors presented with acute onset right-sided hemiparesis, dysarthria, and dysphonia. Symptoms developed a few hours after cannabis ingestion. Neurological examination revealed right facial nerve palsy, vocal cord palsy, and reduced motor strength in the right upper and lower limbs. Non-contrast computed tomography of the brain demonstrated acute bilateral basal ganglia haematomas. Comprehensive evaluation, including autoimmune, infectious, coagulation, and genetic work-up, was unremarkable. Magnetic resonance angiography and venography excluded vascular malformations, aneurysms, and cerebral venous thrombosis. Urine toxicology was positive for cannabis, identifying it as the probable aetiological factor. This case represents a rare presentation of SBBGH associated with cannabis use. It expands the spectrum of cannabinoid-related cerebrovascular complications and highlights the importance of considering substance-related aetiologies in young patients with atypical ICH.