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Synthetic Cannabinoids and Stroke: A Smoking Gun?

Summary and Comment |
December 3, 2013

Synthetic Cannabinoids and Stroke: A Smoking Gun?

  1. Seemant Chaturvedi, MD

Two cases of stroke in siblings who had recently smoked “spice” point to a possible association.

  1. Seemant Chaturvedi, MD

Ischemic stroke in young adults accounts for about 15% of all strokes. The causes can be heterogeneous, and some events remain unexplained (cryptogenic). Newly indentified mechanisms and causative agents are, therefore, of interest.

These authors describe the occurrence of ischemic stroke in two siblings. In the first patient, a 26-year-old man, stroke occurred within hours of smoking “spice,” a synthetic marijuana that is an increasingly popular recreational drug. Investigations failed to reveal an arterial cause or hypercoagulable state. Despite a negative echocardiogram, the imaging studies were suggestive of an embolic stroke. His 19-year-old sister later presented with a left middle cerebral artery territory stroke. History taking was limited by the patient's aphasia, but toxicology studies showed the presence of JWH-018, a synthetic cannabinoid found in spice. No other stroke etiology was identified.

Comment

A consensus panel recently convened by the American Academy of Neurology published a document on recognition and management of stroke in young adults (Neurology 2013; 81: 1089). This publication emphasized the fact that untangling the etiology of stroke in young adults can be challenging. In the current report, circumstantial evidence supports a relationship between spice use and the development of stroke. However, the authors rightly point out that there may be an undiscovered genetic cause in these two siblings. Further reports will be of interest to see whether spice could be a “smoking gun” in some cases of otherwise cryptogenic stroke.

  • Disclosures for Seemant Chaturvedi, MD at time of publication Consultant / Advisory board Abbott Vascular; Boeringher-Ingelheim; Genentech; Thornhill Research Grant / research support Pfizer Editorial boards Neurology; Stroke Leadership positions in professional societies American Academy of Neurology (Vice Chair of Vascular Neurology Section)

Citation(s):

Reader Comments (2)

Dr Lidia Cova Other Healthcare Professional, Neurology

very interesting

Martin Forde, MSc Fellow-In-Training, Pharmacology/Pharmacy

More like, grasping at straws.

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