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TBI and Stroke are acute and potentially fatal injuries involving a primary ischemic attack that restricts blood flow and damages brain tissue. This is followed by secondary injury reactions that can rebound for several weeks or months, resulting in motor impairment, more brain damage, and other adverse effects such as poor concentration, irritability, and sleep problems.

The secondary injury cascade is linked with the development of many of the neurological deficits observed after a TBI or a stroke.

The initial trauma elicits a complex sequence of molecular events, whether the cause is an obstructed blood vessel or blunt external force. These events are associated with a considerable production of glutamate- an excitatory neurotransmitter and the overproduction of free radicals and otherinflammatory compounds. 

Excessive glutamate and oxidative stress leads to 

• Microvascular injury
• Blood-brain barrier breakdown
• Swollen brain tissue
• Calcium ion imbalance
• Neurotoxicity and 
• Cell death. 

Cannabinoids to the rescue

How do cannabis and THC offer neuroprotective effects?

Phytocannabinoids such as THC and CBD mimic and boost the activity of endogenous cannabinoids that all mammals produce naturally. Endogenous cannabinoids are produced by the endocannabinoid system (ECS), which regulates many physiological processes related to TBI, such as inflammation,cerebral blood flow, and neuroplasticity. ECS is a self-protective mechanism. Endocannabinoid levels in the brain rise significantly during and immediately after a TBI. 

These endogenous compounds activate cannabinoid receptors, CB1 and CB2, which protect against TBI-induced neurological and motor deficits. Cannabinoid receptors in the body play an important role in neuroprotection.

When large amounts of glutamate are released, CB1 activity increases to reduce nerve cell damage and transmission. But CB1 also regulates cell death, acting as a switch between cell survival and cell death. A weak CB1 antagonist might limit apoptosis while still reducing glutamate excitotoxicity.

When the CB2 receptor is activated, it promotes cell repair and survival following an ischemic injury. CB2 receptors are present in stem cells and are instrumental in driving neurogenesis (creating new brain cells). Neurogenesis speeds up motor function and overall recovery after TBI. 

CBD improves functional recovery and reduces brain damage in animal models of stroke and TBI. 

CBD helps normalize post-ischemic heart arrhythmia and limits the size of damaged tissue when administered after a closed head injury.

Furthermore, CBD is non-psychoactive, which means it will not produce a high like THC and has no intoxicating side effects. CBD use does not lead to tolerance.

CBD for Chronic traumatic encephalopathy (CTE)

CTE, a particularly morbid form of TBI caused by numerous concussions, increases the danger of neurological issues later in life and speeds up the progression of dementia. Football players are especially vulnerable, considering the aggressive nature of the sport.

A series of suicide and mental health disorders among former star athletes has generated public attention

 after years of official National Football League cover-up and neglect.  

The far-fetched benefits of CBD-rich cannabis oil for CTE are well known among football players, boxers, and other professional athletes prone to head injuries.

The entourage effect is real - CBD works even better when combined with THC and other components of the cannabis plant. Apart from CBD and THC, dozens of cannabis components with specific medical attributes interact synergistically. The therapeutic effect of the whole plant is much greater than the sum of its parts.

Complementary therapies for traumatic brain injury

As complex as a stroke or a TBI can benefit from a combination of healing modalities, including:

• Terpenes- Cannabis products and strains with specific phytocannabinoids. Extracts rich in CBD with as much THC as a person is comfortable with—whole-plant cannabis oil.
• Diet. A high fat, low carbohydrate, or low sugar diet with plenty of leafy greens, omega three oils (DHA, EPA), and fermented foods (probiotics).
• Nutritional supplements and antioxidants. Magnesium, vitamin D, curcumin, glutathione, and melatonin restore circadian rhythms and sleep.
• Ancient therapies. Acupuncture, exercise, and caloric restriction (fasting) increase endocannabinoid levels.
• Modern therapies: These include Neurofeedback, low-level laser therapy (photobiomodulation), hyperbaric oxygen, transcranial direct current stimulation, flotation tank therapy, and hypothermia (cooling).