Cannabidiol’s Multifactorial Mechanisms Has Therapeutic Potential for Aneurysmal Subarachnoid Hemorrhage: a Review

Nicholas Henry, Justin F. Fraser, Joseph Chappell, Tamra Langley, Jill M. Roberts

Research output: Contribution to journalReview articlepeer-review

Abstract

Subarachnoid hemorrhage (SAH) is a major health burden that accounts for approximately 5% of all strokes. The most common cause of a non-traumatic SAH is the rupture of a cerebral aneurysm. The most common symptom associated with SAH is a headache, often described as “the worst headache of my life.” Delayed cerebral ischemia (DCI) is a major factor associated with patient mortality following SAH and is often associated with SAH-induced cerebral vasospasm (CV). Cannabidiol (CBD) is emerging as a potential drug for many therapeutic purposes, including epilepsy, anxiety, and pain relief. We aim to review the potential use of CBD as a treatment option for post-SAH critically ill patients. Through a literature review, we evaluated the known pharmacology and physiological effects of CBD and correlated those with the pathophysiological outcomes associated with cerebral vasospasm following subarachnoid hemorrhage. Although overlap exists, data were formatted into three major categories: anti-inflammatory, vascular, and neuroprotective effects. Based on the amount of information known about the actions of CBD, we hypothesize the anti-inflammatory effects are likely to be the most promising therapeutic mechanism. However, its cardiovascular effects through calcium regulation and its neuroprotective effects against cell death, excitotoxicity, and oxidative stress are all plausible mechanisms by which post-SAH critically ill patients may benefit from both early and late intervention with CBD. More research is needed to better understand if and how CBD might affect neurological and vascular functions in the brain following injury such as subarachnoid hemorrhage.

Original languageEnglish
JournalTranslational Stroke Research
DOIs
StateAccepted/In press - 2022

Bibliographical note

Funding Information:
We would like to thank Tom Dolan, MS (Medical Illustrator, University of Kentucky) for designing Figure . Dr. Chappell's efforts were supported, in part, by an Igniting Research Collaboration grant from the University of Kentucky. Dr. Roberts' efforts were supported, in part, by NIH 5KL2TR001996-04 from the University of Kentucky CCTS.

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • CBD
  • Inflammation
  • Stroke
  • Vasospasm

ASJC Scopus subject areas

  • Neuroscience (all)
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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