Strokes are when blood flow to the brain is limited or interrupted,
potentially causing permanent neural damage. Studies have shown marijuana,
when administered shortly after a stroke, effectively limits 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
Findings: Effects of Cannabis on Stroke
Cannabis has proven to be effective at limiting the cell damage and
providing neuroprotective effects following ischemic events like strokes.
These benefits are due to the presence of one of the major cannabinoids
found in cannabis, cannabidiol (CBD). Administering CBD shortly after a
stroke protects neurons and astrocytes from damage, and therefore leads to
improved functional, histological, biochemical, and neurobehavior recovery (Lafuente,
et al., 2011).
Most research demonstrating CBD’s neuroprotective benefits are found in
animal trials. Piglets given CBD shortly following an ischemic attack were
able to recover their brain’s electrical activity to 46.4% of their baseline
and only 4 out of 8 experienced seizures, compared to piglets that did not
receive CBD, which recovered 20.5% of their brain’s decreased electrical
activity and all experienced seizures. CBD reduced both effects by more than
50% (Alvarez, et al., 2008). In mice and rat trials, CBD has shown to reduce
infarct volume and acute and apoptotic brain damage when administered
shortly after an ischemic brain event (Castillo, et al., 2010) (Mishima, et
al., 2005) (Hayakawa, et al., 2004) (Hayakawa, et al., 2008) (Mishima, et
al., 2005) (Walsh, Hepburn, Kane & Wainwright, 2010). One study found that
administering CBD both before and after a stroke caused potent and
long-lasting neuroprotection (Hayakawa, et al., 2007).
The brain damage that occurs following strokes is associated with increases
in excitotoxicity, oxidative stress and inflammation. However, administering
CBD shortly after a stroke occurs has shown effective at preventing all
three of these alterations (Pazos, et al., 2013) (Pazos, et al., 2012).
These neuroprotective findings have been experienced in human subjects as
well. Cannabinoids administered to humans shortly after experiencing a
stroke caused a reduction in infarct volume and caused significant
improvements in both early and late brain activity scores, thus
demonstrating they improve functional outcome following strokes (England,
Hind, Rasid & O’Sullivan, 2015).
Research suggests that administering CBD as quickly as possible following a
stroke makes a significant impact on its ability to limit damage and improve
recovery. An animal study found that repeated treatment with CBD from 1 and
3 days after a stroke caused a functional improvement and increased survival
rats. When CBD was given 5 days after a stroke, however, it did not improve
ischemic damage (Hayakawa, et al., 2009).
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
conditions subject to approval), and Washington (any
“terminal or debilitating condition”).
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
Administering CBD shortly following an ischemic event caused about a 50%
increase in the recovery of electrical activity in the brain and a 50%
reduction in seizures.
Neuroprotective effects of the nonpsychoactive cannabinodi cannabidiol
in hypoxic-ischemic newborn piglets.
CBD reduced acute and apoptotic brain damage when administered shortly
after an ischemic brain event in mice.
The neuroprotective effect of cannabidiol in an in vitro model of
newborn hypoxic-ischemic brain damage in mice is mediated by CB(2) and
Cannabinoids administered to humans shortly after a stroke reduced
infarct volume and improved brain functional outcome.
Cannabinoids in experimental stroke: a systematic review and
Alvarez, F.J., Lafuente, H., Rey-Santano, M.C., Mielgo, V.E., Gastiasoro,
E., Rueda, M., Pertwee, R.G., Castillo, A.I., Romero, J., and
Martinez-Orgado, J. (2008, December). Neuroprotective effects of the
nonpsychoactive cannabinodi cannabidiol in hypoxic-ischemic newborn piglets. Pediatric
Castillo, A., Tolon, M.R., Fernandez-Ruiz, J., Romero, J., and
Martinez-Orgado, J. (2010, February). The neuroprotective effect of
cannabidiol in an in vitro model of newborn hypoxic-ischemic brain damage in
mice is mediated by CB(2) and adenosine receptors. Neurobiology
England, T.J., Hind, W.H., Rasid, N.A., O’Sullivan, S.E. (2015, March).
Cannabinoids in experimental stroke: a systematic review and meta-analysis. Journal
of Cerebral Blood Flow and Metabolism,
Hayakawa, K., Irie, K., Sano, K., Watanabe, T., Higuchi, S., Enoki, M.,
Nakano, T., Harada, K., Ishikane, S., Ikeda, T., Fujioka, M., Orito, K.,
Iwasaki, K., Mishima, K., and Fujiwara, M. (2009, September). Therapeutic
time window of cannabidiol treatment on delayed ischemic damage via
high-mobility group box1-inhibiting mechanism. Biological
& Pharmaceutical Bulletin,
Hayakawa, K., Mishima, K., Abe, K., Hasebe, N., Takamatsu, F., Yasuda, H.,
Ikeda, t., Inui, K., Egashira, N., Iwasaki, K., and Fujiwara, M. (2004,
October 25). Cannabidiol prevents infarction via the non-CB1 cannabinoid
receptor mechanism. Neuroreport,
Hayakawa, K., Mishima, K., Irie, K., Hazekawa, M., Mishima, S., Fujioka, M.,
Orito, K., Egashira, N., Katsurabayashi, S., Takasaki, K., Iwasaki, K., and
Fujiwara, M. (2008, December). Cannabidiol prevents a post-ischemic injury
progressively induced by cerebral ischemia via a high-mobility group
box1-inhibiting mechanism. Neuropharmacology,
Hayakawa, K., Mishima, K., Nozako, M., Hazekawa, M., Irie, K., Fujioka, M.,
Orito, K., Abe, K., Hasebe, N., Egashira, N., Iwasaki, K., and Fujiwara, M.
(2007, September). Delayed treatment with cannabidiol has a
cerebroprotective action via a cannabinoid receptor-independent
myeloperoxidase-inhibiting mechanism. Journal
Lafuente, H., Alvarez, F.J., Pazos, M.R., Alvarez, A., Rey-Santano, M.C.,
Mielgo, V., Murgia-Esteve, X., Hilario, E., and Martinez-Orgado, J. (2011,
September). Cannabidiol reduces brain damage and improves functional
recovery after acute hypoxia-ischemia in newborn pigs. Pediatric
Mishima, K., Hayakawa, K., Abe, K., Ikeda, T., Egashira, N., Iwasaki, K.,
and Fujiwara, M. (2005, May). Cannabidiol prevents cerebral infarction via a
serotonergic 5-hydroxytryptamine1A receptor-dependent mechanism. Stroke,
Pazos, M.R., Cinquina, V., Gomez, A., Layunta, R., Santos, M.,
Fernandez-Ruiz, J., Martinez-Orgado, J. (2012, October). Cannabidiol
administration after hypoxia-ischemia to newborn rats reduces long-term
brain injury and restores neurobehavioral function. Neuropharmacology,
Pazos, M.R., Mohammed, N., Lafuente, H., Santos, M., Martinez-Pinilla, e.,
Moreno, E., Valdizan, E., Romero, J., Pazos, A., Franco, R., Hillard, C.J.,
Alvarez, F.J., and Martinez-Orgado, J. (2013, August). Mechanisms of
cannabidiol neuroprotection in hypoxic-ischemic newborn pigs: role of
5HT(1A) and CB2 receptors. Neuropharmacology,
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Walsh, S.K., Hepburn, C.Y., Kane, K.A., Wainwright, C.L. (2010, July). Acute
administration of cannabidiol in vivo suppresses ischaemia-induced cardiac
arrhythmias and reduces infarct size when given at reperfusion. British
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