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Post Concussion Syndrome

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Updated on June 29, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer

With approximately 715 emergency room visits due to traumatic head injury in 2010, the Center for Disease Control and Prevention reports a spike in the rates of concussions since 2001. In that timeframe, deaths from concussion were down slightly. Anywhere from 40 to 80% of people who sustain a concussion develop post-concussion syndrome.

Our understanding of post-concussion syndrome is still incomplete. The causes and risk factors can be isolated with medical data but not explained exactly. The condition often resolves on its own after exhibiting debilitating symptoms for weeks or months. Medical marijuana therapy during that time may be the single treatment that can relieve physical and psychological symptoms of post-concussion syndrome.

Medical Marijuana for Post-Concussion Syndrome

It may seem counter-intuitive to add a psychoactive drug to the brain of someone who is experiencing behavioral changes as a result of a brain injury. The most serious damage that can be caused by a concussion is the chemical damage to the brain. In this area, doctors are working with non-specific information and do not have tools to help the brain heal.

A recent study showed the potential effects of cannabis for post-concussion syndrome. Elements in the cannabis reduce swelling in the brain. Swelling causes pressure, damage and pain. A traumatic injury to the brain releases toxic chemicals that cause some of the symptoms of post-concussion syndrome. Marijuana can help clear those chemicals and protect the brain from further damage.

Marijuana also increases blood supply to the brain. This is helpful because the blood brings oxygen and nutrients to help speed healing. It also carries toxins and other byproducts away from the brain. Medical marijuana is also effective in treating anxiety and depression, two symptoms of post-concussion syndrome.

Marijuana may only be treating the symptoms of post-concussion syndrome, but it has few if any side effects and it is one medicine that can address most of the symptoms of this condition. There is very little clinical research so far on the use of medical marijuana for post-concussion syndrome, but it is effective for many of the symptoms.

Referring to medical marijuana, Dr. Jeffrey Hergenrather said that, “In my opinion, there is no better drug for the treatment of anxiety disorders, brain trauma and post-concussion syndrome.” Patients can use sativa-dominant strains to combat their emotional symptoms, depression, headaches and migraines.

How to Use Medical Marijuana for Post-Concussion Syndrome

Cannabis strains are classified by their two main ingredients, THC and CBD. Each has a different effect on the brain, and, when the two are balanced just right, they can relieve your specific combination of symptoms. When dealing with post-concussion syndrome, keep in mind that large doses of THC, the psychoactive ingredient in marijuana, can cause paranoia and hyper-activity.

To treat post-concussion syndrome, you are looking for a low THC strain that is only mildly psychoactive. There should be just enough THC to reduce anxiety and bring about a sense of wellbeing without triggering paranoia. Consider one of these strains that is known to treat depression:

  • Lemon Skunk
  • AK Cherry Lime
  • Glass Slipper
  • Sour Grape
  • Blue Dream

Pain relief is another property of medical marijuana that you’ll need to combat post-concussion syndrome. Headache pain following a concussion is often described as severe and similar to that of a migraine headache. These cannabis strains are the best for migraine headaches:

  • Lemon OG Kush
  • Girl Scout Cookies
  • White Widow
  • Sour Diesel
  • Candyland

Sleep pattern disturbances or insomnia is another common symptom of post-concussion syndrome that can be treated with medical marijuana. Since anxiety can be one of the root causes of this type of insomnia, it is a good idea to go easy on the THC. Medical marijuana that is especially good for trauma-related insomnia has some CBD to balance the effects of THC. These strains are best known for treating insomnia:

  • Girl Scout Cookies
  • Harlequin
  • Grape Ape
  • White Widow
  • Hawaiian Purple Kush

Edible forms of medical cannabis deliver a slow but long-lasting affect. They are the best form of delivery for insomnia because they help you fall asleep and stay asleep for a restful several hours.

Although the symptoms of post-concussion syndrome are temporary, the inability to concentrate and a shortened attention span, along with a general fatigue, can make it impossible to carry out your daily responsibilities. Cannabis strains with a higher CBD to THC ratio can help you stay focused and increase your energy levels. Try these top stains for focus and energy:

  • Green Crack
  • Sour Diesel
  • Harlequin
  • Blue Dream
  • Lemon Haze

Medical marijuana can also be used to treat the dizziness or Vertigo that may accompany post-concussion syndrome. Marijuana is well known for its effectiveness in reducing nausea, especially related to strong chemotherapy courses. Nausea and dizziness often go together. Dizziness is reduced best by these strains of cannabis:

  • Strawberry Cough
  • Green Crack
  • Blue Widow
  • Purple Dream
  • Cinex

A qualified marijuana doctor can recommend the right strain of cannabis to treat your specific combination of symptoms from post-concussion syndrome. There are several ways to consume medical marijuana, so the products you use can also be tailored to your specific medical needs.

Medical marijuana has very few side effects and offers no risk of overdose. With guidance from your doctor, you should be able to remain relatively comfortable while your brain heals the damage caused by a concussion. A side effect of your marijuana treatments might be faster healing and protection of damaged nerves.

Learn More About Medical Marijuana for Post-Concussion Syndrome

If you want to learn more about the medicinal value of cannabis products, sign up for our newsletter. It will keep you updated on medical cannabis research and the medical marijuana program in your state. Did you know many states already approve the use of medical marijuana for chronic pain and migraines? This means that if it is not specifically approved for use on post-concussion syndrome in your state, you may still be treated with marijuana products for your headaches.

While most states’ medical marijuana regulations include a list of approved conditions for treatment with cannabis, several of them also include a clause that allows doctors to make recommendations outside of that specific list if they feel they are medically warranted. Illinois is the first state to include post-concussion syndrome on its list of approved conditions for marijuana treatment. Other states will likely follow their lead.

If you do not have a marijuana doctor, you can find one who is approved in your state by using the search feature on our website. Marijuana Doctors can connect you with a doctor near you who is registered in your state to make medical marijuana treatment recommendations. We can help you become registered as a marijuana patient in your state and help you understand the regulations concerning the use of cannabis for medical purposes.

Compassionate care is available in most states, so people with severe pain or debilitating conditions do not have to suffer. Marijuana Doctors can connect you with the resources you need to access the comforting properties of medical cannabis, whether you are experiencing post-concussion syndrome or some other condition that does not respond to traditional medicinal therapies.

Additional Post-Concussion Syndrome & Cannabis Resources

For more information about how cannabis can be used to treat Post-Concussion Syndrome, check out our resources:

History of Post-Concussion Syndrome

Centuries ago, medical experts were aware that a solid blow to the head could result in cognitive dysfunction, loss of consciousness and a range of mental conditions. These conditions could be acute or become chronic. Although there was no means at the time to see inside the head, doctors were sure the brain could become disturbed by a head injury.

As medical science advanced, we came to understand the brain and central nervous system could be severely affected by trauma to the head. More recently, we learned it is not just the impact on the head that causes these reactions. The shaking motion can damage the brain inside the skull even though there is no injury visible through the skin.

Late in the 19th century, frequent train accidents demonstrated the whiplash style of head injury that results in a concussion. Even if the head does not strike an object, when it is propelled forward quickly and then stopped, the brain inside the skull sustains a concussion. At this time, long-term consequences of concussions became evident.

Simultaneously, sports doctors were concerned with the number of concussions sustained by football players. In 1906, a member of the Harvard Varsity team died from a head injury and drew attention to the severity of football injuries. A study at the time revealed 19 concussions in one season. Doctors noted that players might not be aware of sustaining a concussion during the play.

Without modern medical imaging, it was difficult to determine exactly when a concussion was sustained. If the injury did not result in a visible wound to the head, doctors could not detect the damage to the brain. It was almost impossible to correlate a concussion with subsequent behavioral changes.

Today, a CT scan and an MRI of your head can be used to diagnose a concussion. There may or may not be loss of consciousness with a concussion, but there will be evidence of at least a minor traumatic brain injury. Doctors can diagnose post-concussion syndrome based on a history of concussion and certain behavioral changes that often accompany the condition.

Symptoms of Post-Concussion Syndrome

Post-concussion syndrome can last for days, weeks or months following a head injury. The symptoms can vary and may set in at any time. Following a concussion, symptoms of post-concussion syndrome can include:

  • Sleep pattern disruption
  • Dizziness
  • Depression
  • Headache
  • Increased sensitivity to light and sound
  • Anxiety
  • Memory loss
  • Trouble concentrating
  • Fatigue
  • Vertigo
  • Personality changes
  • Restlessness

Following a traumatic brain injury, the presence of at least three of these symptoms indicates post-concussion syndrome. You don’t have to lose consciousness from the initial concussion to be diagnosed with post-concussion syndrome. Oddly enough, the resulting condition does not appear to have a correlation with how severe the initial blow to head was.

Post-concussion syndrome may result from a seemingly minor head injury while someone sustaining a more severe injury might not develop the condition.

The severity of your concussion and the number of concussions sustained over time are not good indicators of post-concussion syndrome. People over 40 have a higher risk of developing the condition, and women are diagnosed with post-concussion syndrome at a higher rate than men.

There is a chance that people with pre-existing mental health conditions are more likely to develop post-concussion syndrome following a concussion. Some of the symptoms are similar to those of depression and anxiety. Experts note that women may be diagnosed with post-concussion syndrome more frequently than men because they are more likely to seek medical attention, especially for behavioral symptoms.

Treatment for Post-Concussion Syndrome

The full physiology of post-concussion syndrome is not yet known. It results from damage to the brain that causes swelling and bleeding. The inflammation applies pressure to the brain, which can cause headaches and other symptoms.

The shakeup of a concussion also causes changes in your brain chemistry that neuroscientists cannot yet pinpoint. Neurotransmitters, the chemical messengers of the brain, are significantly affected by a concussion, and this shake up results in the symptoms of post-concussion syndrome.

There is no way to heal the brain tissue that was injured. In fact, in some cases, the injured tissue cannot be reached. The treatment for post-concussion syndrome consists of relieving the symptoms so patients can be more comfortable while the brain heals itself naturally.

Headaches and other physical pain from post-concussion syndrome are usually treated with analgesics. This type of pain is sometimes compared to migraines or nerve pain, and it often requires strong pain relievers. Pain relievers, either prescription or over the counter, can worsen post-concussion headaches if over used.

Cognitive impairments brought on by post-concussion syndrome usually resolve themselves in time. These symptoms can be debilitating in the short term, however. Cognitive therapy can be used to learn memory support systems to compensate. Taking notes and using electronic reminders can be helpful to balance loss of memory and short attention span.

The emotional symptoms of post-concussion syndrome may be the most significant. Although these, too, should resolve in time, anxiety and depression can become life-threatening when left untreated. There are some behavioral and drug therapies available to relieve anxiety and depression. Some may also assist with insomnia.

Brain healing is not something doctors have all the specifics on. In most cases, post-concussion syndrome resolves within three months of onset. But, in some cases, the condition lasts for up to a year or longer. There is little that can be done to predict or alter the timeframe for post-concussion syndrome.

Although there is no one treatment specifically designed for post-concussion syndrome, healthcare professionals will often prescribe pharmaceuticals to combat the emotional symptoms which may occur. Additionally, physical and behavioral therapies can be utilized for patients on the road to recovery.

Medical marijuana could help relieve your post-concussion syndrome. Cannabis can help with pain, inflammation plus other symptoms of concussions.

CBD, Traumatic Brain Injury, & Post-Concussion Syndrome

Growing research and evidence shows that there may be some potential between CBD & helping treat TBI.

There is a growing body of evidence indicating that CBD may have potential applications for treating brain injuries, including traumatic brain injuries, and concussion syndrome. Due to the evidence, some athletes and athletic organizations are beginning to encourage research into CBD’s potential benefits for athletes recovering from concussion syndrome or brain injuries.

CBD Patented for Neurological Protection after Trauma

A report published in Proceedings of the National Academy of Sciences in 1998 is credited as one of the first to connect CBD and THC to neuroprotective properties. This groundbreaking study led to a patent confirming that cannabinoids are neuroprotectants and antioxidants.

This study and the patent together further suggest that THC and CBD may act neuroprotectants that could limit the neurological damage that patients experience after trauma, stroke, or other problems that reduce blood flow to the brain.

This is applicable for externally caused Traumatic Brain Injuries (TBI) as well. Given that strokes and TBI share many features, the potential benefit is strong.

Marijuana Users Have Better TBI Outcomes

A 2014 study reported in American Surgeon found that people who consume marijuana and have a traumatic brain injury experience better outcomes than those with a TBI who do not consume marijuana. The results came from a retrospective study that looked at TBI patients who were tested for THC with their symptoms. To avoid skewed results, the study did not look at those with injuries that were unlikely to allow survival. It also ignored patients under 15. The study found that the rate of mortality from the TBIs was significantly lower for those who tested positive for THC.

In other words, those who had THC in their systems at the time of the traumatic brain injury had a lower chance of dying from their brain injuries. This supports the previously mentioned research and patent that THC likely has some neuroprotective properties or at least healing properties in general.

A Potential Explanation of the Protection

An article from the British Journal of Pharmacology in 2011 offered an explanation of how marijuana may protect patients who suffer from brain injuries. According to this report, the endocannabinoid system is “self-protective” and will react to major events like TBI and strokes. Damage from such events causes the accumulation of harmful mediators that induce further damage. However, endogenous production of cannabinoid molecules is triggered in response to the injury and these molecules provide protection and repair, potentially blunting the damage from something such as a head injury. The study found increased endocannabinoid levels within the brain both during and immediately after a TBI. Interestingly, the CB1 and CB2 receptors activated by the endocannabinoid compounds are the same ones that THC activates. Amazingly, the human body’s endocannabinoid system produces these important compounds in response to injury. These cannabinoids activate a cascade of events that may reduce or even reverse the damage caused by a brain injury. While it is clear the CBD and other cannabinoids are the primary components of the cascade and mediate their activity primarily through CB1 and CB2 receptors, the role of THC is not yet well understood in this protection and repair phenomenon.

A 2018 study on mice looked specifically at the CB1 receptor and the response to a TBI or stroke and reinforced the idea that the receptor responds to these traumatic events. It showed that when the CB1 receptor is activated, theoretically by compounds released from injured cells, it will dilate the blood vessels by activating the release of specific cytokines responsible for that mechanism. This increases the blood flow to the brain, which increases the supply of nutrients and oxygen. That type of reaction did not occur in mice that do not have CB1 receptors, confirming that the receptor indeed creates the reaction that is critical for this specific response.

Timing May Matter

Interestingly, research in 2013 found that the extent to which activated CB1 receptors can protect against a TBI depends on the time of the day. This reporting came from a study in rats that found that the survival rate for TBI was higher at times when the CB1 receptors are naturally the least robust.

Activating the CB2 Receptor Is Also Relevant

Other research has shown that the CB2 receptor also plays a role in the potential protection that CBD provides against TBIs. A 2012 report found that activating this receptor reduces the damage to the blood-brain barrier following TBIs in rats. This was followed up by a 2014 report indicating that the CB2 receptor helps regulate the neurovascular response and inflammation in brains that suffered from TBIs.

Sports Organizations Have Started Considering CBD

As mentioned, some of the research into CBD and its potential in treating injuries and pain management has led to increased acceptance. In May 2019, the NFL Players Association and the NFL agreed to study the possibility of using marijuana for pain management for players.

Although this particular application is not directly related to the potential of CBD in treating TBIs, it is relevant given the limited number of effective options proven to effectively mediate the problems associated with brain injury. This is particularly true given the high level of concussions and TBIs associated with football, an elementary reason why an organizations like the National Football League and the NFL Players Association are so interested in the emerging clinical research on CBD and cannabis products.

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There is a growing body of evidence indicating that CBD may have potential applications for treating brain injuries, including traumatic brain injuries, and concussion syndrome. Due to the evidence, some athletes and athletic organizations are beginning to encourage research into CBD's potential… ]]>