Traumatic Brain Injury (TBI) is one of the most common causes of death,  leading to millions of fatalities around the world each year.  “Primary Brain injury is the damage sustained as a direct result of the impact on the skull and intracranial contents.”  Approximately half of the patients with TBI will need to undergo surgery for hematomas and contusions. Life-long disabilities, such as problems with cognition, speech, vision, mood disorders, and memory loss, are also prevalent. 
While many industry professionals view TBI as an “event” requiring short-term medical care, studies indicate that the impact can create a chronic condition.  Following an injury, many patients experience secondary trauma. These incidences can include brain swelling, hematoma formation, hypoxia, and hypotension. 
As we continue to see a rise in TBI from car and cycling accidents to sports-related injuries, it has become imperative to understand the pathological responses to procure appropriate treatment—both short and long term. The goal is to not only stabilize the brain directly following an injury, but to also limit or prevent subsequent deterioration.
A Promising Approach
A new and promising therapeutic approach points to the positive effects of phytocannabinoids and cannabimimetic drugs, isolated from the Cannabis sativa plant.  Research shows that, “Cannabinoids of all classes have the ability to protect neurons from a variety of insults that are believed to underlie delayed neuronal death after traumatic brain injury (TBI), including excitotoxicity, calcium influx, free radical formation, and neuroinflammation.”
Furthermore, an endogenous cannabinoid (2-AG) has been shown to have neuroprotective effects in the brain. Studies deduced that when 2-AG was administered in clinical trials, lab mice experienced a “significant reduction of brain oedema, better clinical recovery, reduced infarct volume, and reduced hippocampal cell death compared with controls.”
Glutamate & Secondary Trauma
Another important aspect of cannabinoid treatment relates to its effects on the production of glutamate. Glutamate is a chemical toxin, often produced after an injury, which causes damage in the brain. Therefore, reducing or inhibiting the release of glutamate may decrease inflammation.
Therapeutic implications suggest, “Cannabinoid receptor agonists inhibit glutamatergic synaptic transmission and reduce the production of tumor necrosis factor-α and reactive oxygen intermediates, which are factors in causing neuronal damage.” When cannabinoid treatment is administered following a traumatic event, evidence suggests that secondary damage is reduced. 
The Right Dose
According to Professor Yosef Sarne of Tel Aviv University, dosing is crucial in the success of treatment with medical marijuana. Professor Sarne found that smaller doses over longer periods of time were most effective to reduce inflammation and subsequent damage. Additionally, tetrahydrocannabinol, or THC, reduced the level of chemicals and free radicals. 
Supporting treatment over a longer durations, as indicated by Professor Sarne, gives validity to the evidence that TBI is a chronic condition. If patients suffer long-term, a continual healing modality administration is likely more beneficial and may help prevent future neurological damage or death.
Cannabis is an ancient medicinal herb that has proven efficacious in a wide range of chronic conditions. From reducing and eliminating anxiety, pain, and insomnia to slowing the progression of diseases such as Alzheimer’s and even certain tumors, it seems that cannabinoids are also proving to help patients with TBI.
For more information about the benefits of medical marijuana and how it can serve your practice, the Holistic Cannabis Academy offers education and training programs for healthcare practitioners, caregivers, and cannabis-curious individuals.
- https://www.sciencedaily.com/releases/2013/05/130530132531.htm OR Miriam Fishbein, Sahar Gov, Fadi Assaf, Mikhal Gafni, Ora Keren, Yosef Sarne. Long-term behavioral and biochemical effects of an ultra-low dose of Δ9-tetrahydrocannabinol (THC): neuroprotection and ERK signaling. Experimental Brain Research, 2012; 221 (4): 437 DOI:10.1007/s00221-012-3186-5
About the Author
Laura Lagano is Co-Founder of the Holistic Cannabis Network, and Education Director of the Holistic Cannabis Academy, Co-Producer of the Holistic Cannabis Summit, whose combined goal is to lift the stigma about medical marijuana. By developing a digital education platform to train a global network of holistic medical cannabis coaches, the intention is to create a paradigm shift about cannabis. As a registered and certified dietitian nutritionist, Laura consults with clients about personalized lifestyle medicine at her private practice Laura Lagano Nutrition in person and online. She has advanced training in nutritional biochemistry from the Institute of Functional Medicine, positioning her to be among a handful of dietitians with certification in functional medicine. Laura entered the fields of nutrition and medicinal cannabis organically — she followed the path set by her children. Raising a child with special needs has provided Laura with deep insight into life as both a parent and a health professional.