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Traumatic Brain Injury (TBI), Stroke

Cannabis for Traumatic Brain Injury (TBI), Stroke

Traumatic brain injuries (TBIs) and strokes are two different conditions. Both can lead to neurotoxicity and cell death, so they’re treated similarly.

Medical cannabis contains phytocannabinoids (plant-derived cannabinoids) with antioxidant, neuroprotective, and potentially neurogenic properties, offering promise as a treatment option. Researchers are especially interested in cannabinoids, terpenes, and flavonoids like cannabidiol (CBD), cannabigerol (CBG), cannabichromene (CBC), beta-caryophyllene (BCP), pinene, limonene, hesperetin, quercetin, and naringin.

clay human brain model

Stroke

A stroke occurs because of a blockage of blood flow or the rupture of an artery, depriving brain cells of oxygen and leading to cell death. Common symptoms include sudden loss of speech, weakness, or paralysis on one side of the body. Each year, over 795,000 people in the United States experience a stroke. Risk factors include smoking, cardiovascular diseases (CVDs), high cholesterol, high blood pressure, obesity, and diabetes.

Traumatic brain injury (TBI)

TBI is a nondegenerative condition caused by force to the head. It can cause temporary or permanent physical, mental, and psychosocial impairments. The CDC estimates that about 1.5 million Americans survive a TBI annually, with approximately 230,000 requiring hospitalization. Those in high-risk professions, such as athletes, construction workers, military personnel, and emergency responders, face an elevated likelihood of TBI.

Both strokes and TBIs are linked to glutamate neurotoxicity, which occurs when excessive glutamate — an excitatory neurotransmitter critical for functions like learning and memory — accumulates in the brain, potentially causing damage.

Stroke/TBI symptoms & health effects

Symptoms often include nerve pain (neuropathy) and headaches, and post-traumatic stress disorder (PTSD) is common. TBIs can also result in long-term cognitive, emotional, and physical issues.

Stroke/TBI diagnosis

Stroke diagnosis

First signs of a stroke typically include:

  • Difficulty with speaking (including slurred speech) and understanding what others are saying
  • Numbness, weakness, or paralysis in the face, arm, and/or leg
  • Vision problems – difficulty seeing from one or both eyes
  • Headache
  • Trouble walking

Diagnosing a stroke involves a combination of clinical assessments and imaging studies:

  • Physical examination: Evaluating neurological functions such as reflexes, muscle strength, and speech
  • Imaging tests:
    • CT scan: Quickly identifies bleeding in the brain or ischemic (caused by lack of blood) stroke
    • MRI: Provides detailed images to detect brain damage and pinpoint the affected area
  • Blood tests: Check for blood-clotting abnormalities and risk factors like high cholesterol or diabetes
  • Electrocardiogram (ECG): Detects heart conditions that could contribute to stroke
  • Carotid ultrasound: Examines blood flow in the carotid arteries

TBI diagnosis

Diagnosing TBI involves evaluating the severity and impact of the injury:

  • Glasgow coma scale (GCS): Measures consciousness level based on eye, verbal, and motor responses
  • Imaging tests:
    • CT scan: Identifies fractures, bleeding, and swelling in the brain
    • MRI: Provides a detailed view of soft tissue injuries
  • Neurological examination: Assesses cognitive and motor skills, memory, and coordination
  • Neuropsychological tests: Evaluates the extent of cognitive impairments and emotional well-being

Stroke/TBI prognosis

Stroke prognosis

The prognosis for stroke depends on factors such as the type, severity, and promptness of treatment. Key considerations include:

  • Recovery timeline: Recovery may take weeks to years, with physical and speech therapy often required
  • Complications: Risk of recurring stroke, physical disabilities, and cognitive impairments
  • Lifestyle changes: Long-term management involves controlling risk factors like hypertension and diabetes

TBI prognosis

The outcome of TBI depends on the severity and quality of care received:

  • Mild TBI: Most patients recover fully with proper rest and care within weeks to months
  • Moderate to severe TBI: Recovery may involve ongoing rehabilitation and coping with permanent disabilities, including changes to senses such as taste and smell. Cognitive and emotional support can improve the quality of life. Those with moderate or severe TBI have a life expectancy nine years shorter than the general population.
  • Risk of secondary injuries: Complications like seizures, infections, or chronic pain may arise

Stroke/TBI treatments

First-line treatments

TBI treatments:

    • Mild cases: Rest, ice packs, and over-the-counter medications like acetaminophen or ibuprofen
  • Severe cases:
      • Surgery (such as craniotomy or carotid endarterectomy)
      • Counseling
      • Rehabilitation, including physical, occupational, and speech therapy
  • Medications:
      • Sedatives (such as benzodiazepines or barbiturates) to reduce intracranial pressure
      • Anticonvulsants (such as gabapentin) for nerve pain
      • Diuretics to drain cerebrospinal fluid
      • Magnesium to improve blood flow and maintain brain homeostasis

Stroke treatments:

  • Clot-busting medications (like alteplase)
  • Blood thinners (like aspirin or clopidogrel)
  • Anticoagulants (warfarin, apixaban)
  • Blood pressure medications (beta-blockers, ACE inhibitors)
  • Statins to lower cholesterol (atorvastatin, pravastatin, simvastatin)

Other treatments

Lifestyle modifications such as exercise and a flavonoid-rich diet are also recommended.

Adjunctive therapy & alternative treatments

Some supplements that can help reduce inflammation, protect against oxidative stress, and reduce nausea, anxiety, or sleep difficulties include:

  • Green and herbal teas like chamomile, ginger, passionflower, and peppermint
  • Omega-3 and vitamin D supplements
  • Fungi such as Lion’s Mane and Turkey Tail
  • Herbs and spices like turmeric/curcumin and black pepper

cannabis tinctures

Cannabis for stroke/TBI

There are various compounds in cannabis with anti-inflammatory, antioxidant, and neuroprotective properties that could help manage some of the symptoms of stroke and TBI.

Potential benefits of medical cannabis:

  • Neuroprotection: Cannabinoids like cannabidiol (CBD) and cannabigerol (CBG) show promise in protecting the brain from neuroinflammation and oxidative stress.
  • Reduction of glutamate toxicity: Tetrahydrocannabinol (THC) may depress glutamate transmission, preventing excessive buildup. THC may also help manage nerve pain.
  • Anti-inflammatory effects: Terpenes (like, limonene, linalool, and beta-caryophyllene) and flavonoids (like naringin and hesperetin) present in cannabis may help reduce inflammation and brain damage
  • Neurogenesis: Cannabinoids like CBD and CBC may promote the generation of new neurons, aiding recovery from injury

Potential cons of medical cannabis:

  • Some studies show an increase in the likelihood of stroke among cannabis users. Many of these dangers may be related to smoking cannabis, but this could hold regardless of the administration route, as THC can increase heart rate.
  • High doses of THC may have adverse effects on short-term memory and balance. Although low doses of THC can reduce anxiety, larger doses may cause anxiety, which can worsen some TBI symptoms.

Evidence and research:

  • A 2021 study highlights the neuroprotective and psychotherapeutic potential of cannabinoids in TBI patients, though more high-quality clinical trials are needed
  • Research into the endocannabinoid system (ECS) suggests it offers druggable targets for treating various types of TBI.

Cannabinoid ratios and formulations:

  • Ratios like THC:CBD 1:20, 1:3, and 1:1 can be dosed to individual needs
  • Products rich in terpenes and cannabinoids like cannabidiolic acid (CBDA), tetrahydrocannabinolic acid (THCA), and cannabidivarin (CBDV) may enhance anti-inflammatory and antioxidant effects

Administration methods:

  • Ingestion:Edibles and capsules for controlled dosing
  • Sublingual:Tinctures for rapid absorption
  • Inhalation:Vaporizers, particularly beneficial for TBI patients needing immediate symptom relief

Additional information for patients

For patients navigating stroke or TBI recovery, additional resources can provide valuable support:

Charities and advocacy groups in the United States

  • American Stroke Association (ASA): Offers education, support groups, and advocacy programs for stroke survivors and their families
  • Brain Injury Association of America (BIAA): Provides information, advocacy, and support for individuals affected by TBI
  • United Spinal Association: Focuses on improving the quality of life for people with spinal cord injuries and related neurological disorders, including TBIs
  • National Stroke Association (NSA): Aims to reduce the incidence and impact of stroke through community programs and education

General tips for patients

  • Stay informed: Regularly consult healthcare providers and reputable resources for the latest treatments and recommendations
  • Join support groups: Engaging with others who have similar experiences can help with emotional and social recovery
  • Monitor symptoms: Keep a journal of any recurring or new symptoms to share with your healthcare team

what are cannabis topicals

Stroke FAQs

What are the early signs of stroke?

Early signs include sudden numbness or weakness (especially on one side of the body), confusion, trouble speaking, difficulty understanding, loss of balance, and severe headache with no known cause.

Can strokes be prevented?

Strokes can often be prevented through healthy lifestyle changes, managing risk factors like hypertension and high cholesterol, and taking prescribed medications for underlying conditions.

What are five things everyone should know about stroke?

  1. Stroke symptoms appear suddenly
  2. Immediate medical attention is crucial
  3. It can happen to anyone at any age
  4. High blood pressure is a leading risk factor
  5. Strokes are treatable and often preventable

What type of support do stroke patients need?

Stroke patients benefit from medical care, physical and speech therapy, emotional support, and assistance with daily activities. Joining support groups and engaging with community resources can also help.

Can using cannabis cause strokes?

While some studies suggest heavy cannabis use may increase stroke risk, the evidence is not definitive, and more research is needed. Patients should consult their healthcare provider.

Traumatic Brain Injury (TBI) FAQs

What are the most common causes of TBI?

The most common causes include falls, motor vehicle accidents, sports injuries, and violent occurrences such as assaults or gunshot wounds.

How long does a TBI last?

The duration of a TBI varies widely, from a few days or weeks (in mild cases) to lifelong effects (in severe cases).

Can a TBI cause a change in personality?

Yes. TBIs can lead to changes in personality due to damage in brain regions that regulate emotions, behavior, and social interactions.

What is the life expectancy of someone with a traumatic brain injury (TBI)?

Life expectancy depends on the injury’s severity and complications, but those with moderate to severe TBI may have reduced lifespans compared to the general population.

Can the brain rewire itself after a TBI?

Yes, it can. The brain has neuroplasticity, allowing it to adapt and rewire itself after injury. Rehabilitation therapies play a key role in enhancing this process.

Can cannabidiol (CBD) protect or reduce damage from a TBI?

Preliminary research suggests CBD may have neuroprotective effects and help reduce inflammation, but more clinical studies are needed to confirm its efficacy and safety for TBI patients.

Resources

Please note: the information in this article does not constitute medical advice.

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Animal Study

15

Clinical Meta-analysis

1

Clinical Trial

1

Double Blind Clinical Trial

4

Laboratory Study

2

Meta-analysis

31

Total studies

Traumatic Brain Injury (TBI), Stroke

54

Positive

50 studies

93%

Inconclusive

2 studies

4%

Negative

2 studies

4%

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