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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 l…