Traumatic Brain Injury

Traumatic Brain Injury (TBI) occurs when an external force delivers a violent blow to the head, resulting in brain dysfunction. Blunt force trauma, penetrating injury and a severe skull fracture can cause TBI. TBI may be mild, with temporary brain damage, or may be quite serious, causing permanent and long-term complications and death.

The symptoms of TBI vary widely and can include headache, nausea or vomiting, fatigue, difficulty sleeping, loss of balance, sensitivity to light or sound, seizures, communication problems, memory or concentration problems, mood swings, feeling depressed and/or anxious, slurred speech, agitation and combativeness. TBI has been linked to dementia and chronic neurodegenerative changes in the brain. TBI interferes with quality of life for both the patient and his or her loved ones.

After initial treatment and stabilization of the head injury, most patients with TBI must go through rehabilitation to relearn basic life functions and how to perform daily activities. These patients often end up on multiple medications, such as sleeping pills, antidepressants, anti-anxiety medications, mood stabilizers, anticonvulsants, pain relievers and antipsychotics.

According to recent research, chronic traumatic brain inflammation, also called chronic traumatic inflammatory encephalopathy, is a major contributing factor to post-traumatic neurodegeneration. Cannabinoids are proven neuroprotective agents with potent anti-inflammatory properties and are being researched as potential treatment for TBI patients. Unfortunately, human research is limited but animal studies are promising.

• Endocannabinoids are significantly increased immediately after brain injury, suggesting that they have a neuroprotective role.^1,2,3
• Endocannabinoids are found to decrease the intensity and duration of toxicity to brain cells after induced chemical damage.^4,5,6
• Endocannabinoids lessen the inflammatory process and enhance brain cell survival after injury.^7,8,9,10,11
• Synthetic cannabinoids given to animals with brain injury protected against brain cell death and injury in multiple studies.^{12,13,14 ,15}
• Cannabidiol (CBD) given immediately after oxygen and blood flow were cut off reduced neuronal injury, cerebral hemodynamic impairment, brain edema and seizures and restored motor and behavioral performance in the 72 hours after the insult.¹⁶

In the only human data looking at the relationship between cannabis and TBI, a 3-year retrospective review revealed that a positive THC screen was associated with decreased mortality in adult patients sustaining TBI; mortality of patients with positive THC test was 2.4% and with a negative THC test was 11.5%.¹⁷

In my clinical experience, patients with TBI benefit greatly with the use of cannabis. Patients report relief of pain, enhanced sleep, less agitation, and mood stabilization. They report no adverse side effects from cannabis use and are able to discontinue most, if not all, pharmaceuticals. Depending on personal preference, some are using only CBD-rich cannabis and others are using combination CBD+THC cannabis. I encourage all of my patients with TBI to include CBD rich cannabis in their regimen.