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 |
|---|---|---|---|
| Psychotic Reactions Following Cannabis Use in East Indians Patients at an Indian drug addiction clinic who developed acute cannabis-related psychosis | 1974 | Descriptive report (case series of clinical observations) | n = 200 |
| Psychiatric effects of cannabis use Swedish cases of cannabis psychosis | 1985 | Case series | n = 70 |
| Forty-Six Cases of Psychosis in Cannabis Abusers Gunila Bernhardson Habitual cannabis users treated for psychosis at Swedish psychiatric clinics and mental... | 1972 | Case series (retrospective survey of psychiatric records) | n = 46 |
| 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 |