title: Synthetic cannabis and acute ischemic stroke.
abstract: An association between marijuana use and stroke has been previously reported. However, the health risks of newer synthetic cannabinoid compounds are less well known. We describe 2 cases that introduce a previously unreported association between synthetic cannabis use and ischemic stroke in young adults. A 22-year-old woman presented with dysarthria, left hemiplegia, and left hemianesthesia within hours of first use of synthetic cannabis. She was healthy and without identified stroke risk factors other than oral contraceptive use and a patent foramen ovale without venous thromboses. A 26-year-old woman presented with nonfluent aphasia, left facial droop, and left hemianesthesia approximately 12 hours after first use of synthetic cannabis. Her other stroke risk factors included migraine with aura, oral contraceptive use, smoking, and a family history of superficial thrombophlebitis. Both women were found to have acute, large-territory infarctions of the right middle cerebral artery. Our 2 cases had risk factors for ischemic stroke but were otherwise young and healthy and the onset of their deficits occurred within hours after first-time exposure to synthetic cannabis. Synthetic cannabis use is an important consideration in the investigation of stroke in young adults.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Neurology, Boston Children's Hospital, Boston, Massachusetts. Electronic address: miya.bernson-leung@childrens.harvard.edu.
authors.forename: Miya E
authors.initials: ME
authors.lastname: Bernson-Leung
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Lester Y
authors.initials: LY
authors.lastname: Leung
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000208:Acute Disease; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002545:Brain Ischemia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D002186:Cannabinoids / Q000009:adverse effects* / Q000138:chemical synthesis; D002533:Cerebral Angiography / Q000379:methods; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008385:Marijuana Smoking / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D002186:Cannabinoids
keywords: Ischemic stroke; acute stroke; cannabis; drugs of abuse; stroke in young adults