Table 4 Cannabinoids in clinical TBI populations
Cannabis use | Dose | Study type | n | Injury | Time frame | Results | References |
|---|---|---|---|---|---|---|---|
Phytocannabinoids | |||||||
Self-reported voluntary use of cannabis | n/a | Prospective Observational | 307 | mTBI; physician diagnosed | Recruitment within 1 week of injury and follow-up at least 4 week post-injury | Cannabis use was not associated with improved recovery rate; cannabis use was associated with reduced symptom severity 3–4 week post-injury | [144] |
Self-reported voluntary use of cannabis | n/a | Survey | 163 | mTBI; United States Military Veterans | Variable (reported use in past month) | Cannabis was used for management of mTBI-related symptoms (sleep, pain, neuropsychiatric symptoms); cannabis use alone was not sufficient for symptom relief | [148] |
THC-positive toxicology screen | n/a | Retrospective observational | 538 | TBI, variable severity | Toxicology screen upon presentation to hospital | Positive THC screen was associated with lower mortality than patients with negative THC screen | [145] |
THC-positive toxicology screen | n/a | Retrospective observational | 4849 | Trauma (severe) with TBI | Toxicology screen upon presentation to hospital | Positive THC screen was associated with shorter hospital stay and shorter duration of ventilator use | [146] |
THC-positive toxicology screen | n/a | Retrospective observational | 2754 | Severe TBI | Toxicology screen upon presentation to hospital | Positive THC screen was associated with lower risk of hemorrhagic stroke; no effect on thromboembolic outcomes, mortality, or length of hospital stay | [147] |
Synthetic cannabinoids | |||||||
Dexanabinol (synthetic cannabinoid derivative; NMDA receptor antagonist) | 48 mg or 150 mg (i.v.; single administration) | Phase II RCT (not powered to test efficacy) | 67 | Severe, closed-head TBI (score of 4–8 on Glasgow Coma Scale) | Within 6 h of injury | Primary Outcome: Treatment was safe and well-tolerated Additional Outcomes: Treatment lowered intracranial pressure; reduced hypotensive episodes; improved cranial perfusion pressure; associated with improved recovery 1 month post-injury | [149] |
Dexanabinol (synthetic cannabinoid derivative; NMDA receptor antagonist) | 150 mg (i.v.; single administration) | Phase III RCT | 861 | TBI (score of 2–5 on Glasgow Coma Scale) | Within 6 h of injury | Primary Outcome: Treatment was safe and well-tolerated. No evidence of improved recovery with treatment 6 month post-injury | [150] |