Stroke due to Bonzai use: two patients.

INTRODUCTION Synthetic cannabinoids are increasingly used all over the world as marijuana substitutes. They have various names such as spice and bonzai in different countries. Cardiovascular or cerebrovascular events associated with cocaine, heroin and amphetamine abuse have been frequently reported. [1] However, stroke associated with the synthetic cannabinoids use is rarely reported. There are only a few case reports in association with synthetic cannabinoids use. [2–4] Bernson-Leung et al [5] described 2 cases that introduce a previously unreported association between synthetic cannabinoids use and ischemic stroke in young adults. Here, we report two patients with stroke that occured shortly after synthetic cannabinoids use. CASE 1 A 35-year-old man was brought to the emergency department with complaints of left sided weakness and facial paralysis starting 3 days before admission. He has no family history for hypercoagulability, congenital heart disease, arrhythmias, stroke, or stroke risk factors. His blood pressure on admission was 138/78 mmHg and electrocardiography revealed sinus tachycardia at 110 beats/minute. Diffusion weighted magnetic resonance and apparent diffusion coeffecient images showed right middle cerebral artery territory infarction (Figure 1). His laboratory investigations were all within normal limits. He stated smoking of bonzai (synthetic cannabinoids) a few hours prior to his symptoms onset and that he