A Case of Synthetic Cannabinoid Induced Ischemic Stroke in A 20 Year Old Female

Abstract

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.

Broad and Region-Specific Impacts of the Synthetic Cannabinoid CP 55,940 in Adolescent and Adult Female Mouse Brains

“…CP 55,940 and other synthetic cannabinoids are highly potent and efficacious CB 1 agonists associated with extreme psychological and physiological effects ( Hudson and Ramsey, 2011 ; Castaneto et al, 2014 ; Fantegrossi et al, 2014 ; Davidson et al, 2017 ; Moeller et al, 2017 ; Samra et al, 2017 ; Manix et al, 2018 ). While there are similarities in some physiological effects between cannabis and synthetic cannabinoids, life-threatening reactions which have been attributed to synthetic cannabinoids are not associated with cannabis use alone ( Underwood, 2015 ; Davidson et al, 2017 ; Manix et al, 2018 ). This is mostly attributed to higher potency and efficacy at CB 1 ( Pacher et al, 2018 ), although there are also “off-target” effects of synthetic cannabinoids and differences in metabolism that may be driving these adverse effects ( Fantegrossi et al, 2014 ).…”

“…Some of the effects of these compounds are severe and detrimental to public health ( Castaneto et al, 2014 ; Müller et al, 2015 ). There are reports of heart attacks, kidney failure, psychosis, and even deaths in people who consumed synthetic cannabinoids ( Davidson et al, 2017 ; Moeller et al, 2017 ; Samra et al, 2017 ; Manix et al, 2018 ). Tragically, most of these people were young and apparently healthy ( Underwood, 2015 ; Samra et al, 2017 ; Manix et al, 2018 ).…”

“…There are reports of heart attacks, kidney failure, psychosis, and even deaths in people who consumed synthetic cannabinoids ( Davidson et al, 2017 ; Moeller et al, 2017 ; Samra et al, 2017 ; Manix et al, 2018 ). Tragically, most of these people were young and apparently healthy ( Underwood, 2015 ; Samra et al, 2017 ; Manix et al, 2018 ). Given unknown effects on the developing brain, the prevalence of synthetic cannabinoid use amongst teenagers and young adults is of particular concern.…”