Synthetic cannabis and acute ischemic stroke

J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):1239-41. doi: 10.1016/j.jstrokecerebrovasdis.2013.07.030. Epub 2013 Oct 8.

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.

Keywords: Ischemic stroke; acute stroke; cannabis; drugs of abuse; stroke in young adults.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anticoagulants / therapeutic use
  • Brain Ischemia / chemically induced*
  • Brain Ischemia / diagnosis
  • Brain Ischemia / drug therapy
  • Cannabinoids / adverse effects*
  • Cannabinoids / chemical synthesis
  • Cerebral Angiography / methods
  • Female
  • Humans
  • Infarction, Middle Cerebral Artery / chemically induced*
  • Infarction, Middle Cerebral Artery / diagnosis
  • Infarction, Middle Cerebral Artery / drug therapy
  • Magnetic Resonance Imaging
  • Marijuana Smoking / adverse effects*
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Anticoagulants
  • Cannabinoids