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Strokes are when blood flow to the brain is limited or interrupted, potentially causing permanent neural damage. Studies have shown cannabinoids, when administered shortly after a stroke, effectively limit brain damage and improves recovery.
Overview of Stroke
A stroke is when blood flow to the brain is interrupted or markedly limited. The brain tissue is deprived of oxygen and nutrients, which can cause brain cells to die within minutes. Strokes are caused by blocked arteries, which is referred to as an ischemic stroke and accounts for about 85% of all strokes, or by the leaking of a blood vessel, which is called a hemorrhagic stroke. A transient ischemic attack (TIA) is when there is a temporary disruption of blood flow to the brain.
Prompt medical response to a stroke helps minimize brain damage. Unfortunately, strokes can be asymptomatic and it’s not uncommon for one to be unaware they’ve suffered a stroke. The common signs of a stroke include slurred speech, confusion, numbness or paralysis of the face, arm or leg, sudden blurred or blackened vision, a sudden headache that could be accommodated with nausea, and trouble walking.
Strokes can cause both temporary and a permanent disability, depending on how long blood flow is disrupted and which part of the brain was affected. Seizures, paralysis, difficulty talking or swallowing, memory loss, emotional problems, and pain are complications that can develop following a stroke. If the stroke affected the right side of your brain, movement and sensation on the left side of the body could be impaired. If the stroke damaged the right side of the brain, movement and sensation on the left side could be affected. Damage on the left side of the brain can also cause speech or language problems.
An array of risk factors can increase the risk of a stroke. These include: being overweight or obese, heavy drinking, use of cocaine and methamphetamines, cigarette smoking, and physical inactivity. Those who have high blood pressure, high cholesterol, diabetes, cardiovascular disease or obstructive sleep apnea also have a higher risk of experiencing a stroke. In addition, African-Americans have a higher risk of stroke than people of other races and men have a higher overall risk than women. Being over the age of 55 is also associated with a greater risk of stroke.
Following ischemic strokes, medical professionals work to restore blood flow to the brain as quickly as possible through a variety of treatment procedures, which can include the administration of aspirin or tissue plasminogen activator (TPA). In some cases, a catheter may be needed to maneuver a tiny decide into the brain to physically break up or remove the clot blocking blood flow. Following a hemorrhagic stroke, doctors will attempt to control bleeding with anti-platelet drugs or through the surgical repair of the leaking blood vessel. Stroke survivors will likely have to participate in a rehabilitation program to recover physical and speech abilities.
Findings: Effects of Cannabis on Stroke
Cannabinoids have shown to be effective at limiting the cell damage and providing neuroprotective effects following ischemic events like strokes. Administering cannabinoids shortly after a stroke protects neurons and astrocytes from damage, and therefore leads to improved functional, histological, biochemical, and neurobehavior recovery6,7.
The beneficial neuroprotective effects of cannabinoids following stroke are related to their influence on the body’s endocannabinoid system, a regulatory network tasked with keeping many of the body’s functions in balance. Cannabinoids interact with the endocannabinoid system through its cannabinoid receptors, CB1 and CB2.
Researchers have found that it is specifically the inhibition of CB1 receptor activation with an increased CB2 receptor activation produces beneficial effects following an ischemic event like a stroke3. Offers neuroprotective effects, It’s the CB2 receptor, which regulates the inflammatory response, that’s been found to drive neurogenesis and improve motor functional recovery after stroke1,6.
Study findings also suggest that prolonged cannabis use reduces the risk of stroke by improving oxygen and blood flow to the brain2.
States That Have Approved Medical Marijuana for Stroke
Currently, no states have approved medical marijuana specifically for the treatment of stroke. However, a number of states will consider allowing medical marijuana to be used for the treatment of stroke with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect on Stroke
- Bravo-Ferrer, I., Cuartero, M.I., Zarruk, J.G., Pradillo, J.M., Hurtado, O., Romera, V.G., Diaz-Alonso, J., Garcia-Segura, J.M., Guzman, M., Lizasoain, I., Galve-Roperh, I., and Moro, M.A. (2016). Cannabinoid type-2 receptor drives neurogenesis and improves functional outcome after stroke. Stroke, 48(1), 204-212. Retrieved from http://stroke.ahajournals.org/content/48/1/204.long.
- Filbey, F.M., Aslan, S., Lu, H., and P., S. (2017). Residual effects of THC via novel measures of brain perfusion and metabolism in a large group of chronic cannabis users. Neuropsychopharmacology, 43, 700-7. Retrieved from https://www.nature.com/articles/npp201744.
- Hillard, C. J. (2008). Role of cannabinoids and endocannabinoids in cerebral ischemia. Current Pharmaceutical Design, 14(23), 2347–2361. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2581413/.
- Stroke. (2015, July 30). Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/stroke/home/ovc-20117264.
- Ward, S.J., Castelli, F., Reichenbach, Z.W., and Tuma, R.F. (2018, February 15). Surprising outcomes in cannabinoid CB1/CB2 receptor double knockout mice in two models of ischemia. Life Sciences, 195, 1-5. Retrieved from https://www.sciencedirect.com/science/article/pii/S002432051730677X?via%3Dihub.
- Zarruk, J.G., Fernandez-Lopez, D., Garcia-Yebenes, I., Garcia-Gutierrez, M.S., Vivancos, J., Nombela, F., Torres, M., Burguete, M.C., Manzanares, J., Lizasoain, I., Moro, M.A. (2012, January). Cannabinoid type 2 receptor activation downregulates stroke-induced classic and alternative brain macrophage/microglial activation concomitant to neuroprotection. Stroke, 43(1), 211-9. Retrieved from http://stroke.ahajournals.org/content/43/1/211.long.
- Zhang, M., Adler, M.W., Abood, M.E., Ganea, D., Jallo, J., and Tuma, R.F. (2009). CB2 receptor activation attenuates microcirculatory dysfunction during cerebral ischemic/reperfusion injury. Microvascular Research, 78(1), 86–94. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3319431/?report=classic.