title: Ischemic stroke associated with the use of a synthetic cannabinoid (spice).
abstract: Synthetic cannabinoids, i.e. "spice", are psychoactive drugs with increasing use worldwide. Spice may have harmful neuropsychiatric and physical side effects. Here, we present the case of a 25-year-old man with ischemic stroke after smoking spice on the previous evening. Diagnostic work-up was negative for other common causes of stroke. Toxicology screen unveiled the cannabimimetic ADB-FUBINACA in the drug sample and in patient's urine. The cardiac sympathomimetic effect of spice might have triggered an unnoticed episode of tachyarrhythmia and resulted in stroke via cardioembolic etiology. Thus, in absence of other risk factors, a careful patient history of spice use is recommended for patients with acute neurological deficits.
authors.affiliation: Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: sebastian.moeller@uk-erlangen.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Moeller
authors.affiliation: School of Medicine and Health Sciences, University Hospital, Karl-Jaspers-Klinik, Department of Psychiatry and Psychotherapy, Medical Campus University of Oldenburg, Bad Zwischenahn, Germany. Electronic address: caroline.luecke@uni-oldenburg.de.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lücke
authors.affiliation: Department of Neuroradiology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: tobias.struffert@uk-erlangen.de.
authors.forename: Tobias
authors.initials: T
authors.lastname: Struffert
authors.affiliation: Department of Forensic Medicine, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: bernhard.schwarze@recht.med.uni-erlangen.de.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schwarze
authors.affiliation: Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: stefan.gerner@uk-erlangen.de.
authors.forename: Stefan T
authors.initials: ST
authors.lastname: Gerner
authors.affiliation: Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: stefan.schwab@uk-erlangen.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Schwab
authors.affiliation: Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: martin.koehrmann@uk-erlangen.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Köhrmann
authors.affiliation: Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: kristin.machold@uk-erlangen.de.
authors.forename: Kristin
authors.initials: K
authors.lastname: Machold
authors.affiliation: School of Medicine and Health Sciences, University Hospital, Karl-Jaspers-Klinik, Department of Psychiatry and Psychotherapy, Medical Campus University of Oldenburg, Bad Zwischenahn, Germany. Electronic address: alexandra.philipsen@uni-oldenburg.de.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Philipsen
authors.affiliation: School of Medicine and Health Sciences, University Hospital, Karl-Jaspers-Klinik, Department of Psychiatry and Psychotherapy, Medical Campus University of Oldenburg, Bad Zwischenahn, Germany; Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: helge.mueller1@uni-oldenburg.de.
authors.forename: Helge H
authors.initials: HH
authors.lastname: Müller
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000139:chemically induced*; D002186:Cannabinoids / Q000009:adverse effects*; D015198:Designer Drugs / Q000009:adverse effects*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D020521:Stroke / Q000139:chemically induced*
chemical_list: D002186:Cannabinoids; D015198:Designer Drugs; D013287:Illicit Drugs
keywords: Abuse; Spice; Stroke; Synthetic cannabinoid