Stroke after Marijuana smoking in a teenager with factor V Leiden mutation
ABSTRACT: Factor V Leiden is a well-recognized etiology of venous thrombosis, but reports of stroke in patients with this mutation are few. Marijuana smoking has rarely been associated with thrombosis of cerebral and renal arteries and may be due to a direct toxic effect on the endothelium. Reported here is the case of a previously healthy young man who smoked marijuana on a daily basis and had an occipital lobe stroke; he was found to be heterozygous for factor V Leiden. This case suggests that marijuana smoking may increase the risk of arterial thrombosis in otherwise healthy individuals who are heterozygous for factor V Leiden.
STROKE IN YOUNG PATIENTS has various etiologies, including cardiac, vascular, and hypercoagulable disorders. The factor V Leiden mutation is a common cause of unprovoked venous thrombosis in the white population. Use of oral contraceptives may increase the risk of cerebral venous thrombosis in women who carry this mutation. However, few cases of factor V Leiden mutation associated with cerebral arterial thrombosis and stroke have been reported. (1) Some studies have found an increased risk of cerebral arterial thrombosis in patients with this mutation, but other reports are conflicting. Reported here is the case of a young man who regularly smoked marijuana, had an occipital lobe stroke, and was found to be heterozygous for factor V Leiden.
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