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We report a 21-year old man with cerebral vasculopathy and concurrent ischemic and hemorrhagic strokes shortly after his first exposure to an “energy drink” containing numerous sympathomimetic herbal compounds.
Several hours after drinking 250 mL of the energy drink XS Cranberry–Grape Blast, the patient had onset of profound headache and hemiataxia while on a hike with friends. His medical history included type I diabetes, asthma, and remote syncope. He denied exposure to over-the-counter stimulants, cold preparations, diet aids, or illicit drugs.
On examination, he had photophobia and marked hemiataxia. His imaging revealed an acute brainstem infarction and bilateral subarachnoid hemorrhage on the cerebral convexities (figure). CSF analysis confirmed subarachnoid blood without elevation of white blood cells …
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