Synthetic cannabinoids, also known as "K2" or "spice", refer to a recreational drug that is chemically synthesized and becoming more frequently abused. Although many of the symptoms from acute intoxication of synthetic cannabinoids are similar to marijuana, there are additional adverse effects that are unique to the synthetic cannabinoids. We present a patient who presented to the hospital with acute encephalopathy/amnestic episode for 1-day duration and symptoms of abulia. An extensive workup in the hospital for common causes of acute encephalopathy came negative, but an MRI ended up showing findings consistent with acute ischemic stroke of the right caudate nucleus. Acute ischemic stroke has been described in the literature as an adverse effect from synthetic cannabinoids, but the mechanism of causing stroke is currently unclear. Physicians should be alerted to the potential adverse effects of synthetic cannabinoids and should consider synthetic cannabinoids as an etiology in patients presenting with symptoms consistent with an acute ischemic stroke.
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