Traumatic Brain Injury (TBI), Stroke and Medical Cannabis

Definition

Stroke is caused by a blockage of blood flow or rupture of an artery, leading to a lack of oxygen going through to brain cells and cell death. Common symptoms include sudden loss of speech, weakness or paralysis of one side of the body.

Traumatic brain injury (TBI) is a nondegenerative, non-congenital condition caused by external mechanical force to the head. This can lead to temporary or permanent impairment of physical, mental and psychosocial functions.

Potential Efficacy / Quality of Evidence (Low, Average, High) of Medical Marijuana for TBI & Stroke

Average

Cannabinoids, Terpenes/Terpenoids, Strains and Ratios that May Help

CBD and CBC may help protect the brain.

CBDA, THCA and CBDV may also be helpful.

Terpenoids such as limonene, pinene, linalool, beta-caryophyllene and humulene could also be helpful for stroke/TBI.

CBD:THC 20:1; CBD:THC 1:1

Medical MMJ Pros

Some evidence to suggest that CBD may protect against myocardial ischemic reperfusion injury [1].

CBD could possibly prevent infarction [2] and cerebral infarction via the non-CB1 cannabinoid receptor mechanism [3].

Cannabis contains compounds that are neuroprotective antioxidants [4].

There is the possibility that cannabinoids reduce or even reverse may long-term brain injury [5].

CBD could prevent cell death [6].

May be neuroprotective [7] and help prevent an overabundance of glutamate from forming.

Medical MMJ Cons

There are some studies that show an increase in the likelihood of stroke amongst cannabis users.

High doses of THC may make have negative effects on short-term memory and balance.

More About the Condition

Strokes occur when a part of the brain has inadequate blood flow, either from a blockage of a blood vessel (ischemic) or bleeding directly onto the brain or the space in between the brain’s membranes (hemorrhagic), eventually resulting in brain cell death. An inability to feel or move on one side of the body, a loss of vision to one side, migraine, problems understanding or speaking and a “spinning” feeling are all signs of a stroke. High blood pressure is a big risk factor in suffering a stroke. Obesity, tobacco smoking, high blood cholesterol, diabetes, a previous traumatic brain injury (TBI) and atrial fibrillation are all also risk factors for a stroke.

There is mixed evidence on cannabis and strokes, although there may be more help in cannabis for those who have TBIs from sports injuries. There are several studies that show a correlation between the use of cannabis and the likelihood of a stroke; but, as they say, correlation does not necessarily mean causation, and there are many factors to account for, including diet, tobacco smoking and previous TBIs.

There is also a not-insignificant amount of scientific research into the use of cannabinoids to treat TBIs, as cannabinoids such as CBD may help protect the brain from neuroinflammation. There are several cannabinoids, including THC and CBD, that may help prevent dangerous amounts of glutamate forming, which can actually potentially prevent strokes.

Quotes from Experts

“The inherent polypharmaceutical properties of cannabis botanicals offer distinct advantages over the current single-target pharmaceutical model and portend to revolutionize neurological treatment into a new reality of effective interventional and even preventative treatment.” Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200872/ [8]