Delayed Intracerebral Hemorrhage after Synthetic Cannabis (Bonsai) Abuse; Case Report and Literature Review.
Gülçin Aydin, Bülent Bakar
Bulletin of emergency and trauma July 2019 DOI: 10.29252/beat-0703019 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 25-year-old man who used the synthetic cannabinoid "bonsai" |
| Topics | Cannabis |
| Keywords | Ground-glass appearance Intracranial hemorrhage |
| Key findings | In a 25-year-old man who used the synthetic cannabinoid "bonsai", respiratory complications (diffuse alveolar hemorrhage suggested by chest CT) were followed by delayed intracranial hemorrhage in the left frontal and right posterior parietal regions, requiring a second intubation; he recovered consciousness three weeks later. The authors advise clinicians to consider life-threatening intracranial complications in synthetic cannabinoid users in both early and late phases. |
Abstract
Bonsai is a synthetic cannabinoid (SC) substance which can cause lung toxicity with chronic use. However, there are few case reports in literature related to bonsai-induced intracerebral hemorrhage in literature. A 25-year-old man presented at the Emergency Room (ER) with dyspnea, hemoptysis and agitation subsequent to bonsai use. He became unconscious in ER and was then intubated and admitted to the intensive care unit (ICU). The cranial computed tomography (CT) scan was non-specific and a thoracic CT scan revealed consolidation and the appearance of " ground-glass " in the lung, and therefore, development of diffuse alveolar hemorrhage was considered. The patient recovered consciousness on the second day of hospitalization and was extubated. During follow-up, he lost consciousness once again and on the cranial CT images, hemorrhage areas located in the left frontal and right posterior parietal regions were observed. Nevertheless, no surgical intervention was considered. The patient recovered consciousness three weeks after the second intubation and was transferred to the psychiatry clinic. In patients with synthetic cannabinoid substance abuse, life-threatening intracranial complications in the early and/or late phase should be kept in mind in addition to respiratory and systemic complications in the acute phase.
Comparable studies
Other case reports and case series on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication | 2005 | Case study | n = 1 |
| Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... | 2001 | Case series | n = 3 |
| “Hallucinations” Following Acute Cannabis Dosing: A Case Report and Comparison to Other Hallucinogenic Drugs Healthy 30-year-old male | 2018 | Case study | n = 1 |
| Hallucinogen persisting perception disorder: A literature review and three case reports Patients with hallucinogen persisting perception disorder | 2018 | Case series | n = 3 |
| Cannabis Psychosis in Young Psychiatric Inpatients Consecutive psychiatric hospital admissions of patients aged 35 and under | 1986 | Case study | n = 25 |