title: Psychosis following traumatic brain injury and cannabis use in late adolescence.
abstract: BACKGROUND
  Both cannabis and traumatic brain injury (TBI) pose risks on the developing brain, including a potential increased vulnerability for developing psychosis. Recent reports detail an upward trend in both adolescent cannabis use and the concentration of THC, the most potent psychoactive component in cannabis. Similarly, it is estimated that 1.7 million Americans incur a TBI each year. Previously trivialized as a minor nuisance, attitudes towards TBIs are changing as researchers and the public recognize TBIs' possible long-lasting sequelae.
  
  
  METHODS
  Two cases are presented of adolescent patients with histories of TBI and self-reported heavy, recreational cannabis use who developed symptoms of psychosis.
  
  
  CONCLUSIONS
  Similar neuronal signaling pathways involved in cannabis ingestion and TBI recovery, specifically CB1 receptors of the endocannabinoid system, as well as the allostatic load model provide context for the two presented cases. Given the cases and theories presented, we believe that cannabis use may act as a neurological stressor and risk factor for psychosis outweighing its possible benefits as a therapeutic solution for pain in late adolescent and young adult populations.
  
  
  CONCLUSIONS
  The presented cases provide further support for the compounded risk of developing psychosis following TBI and cannabis use.
authors: Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Waltham, Massachusetts.
authors: Jonathan
authors: J
authors: Rabner
authors: Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Waltham, Massachusetts.
authors: Sarah
authors: S
authors: Gottlieb
authors: Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Waltham, Massachusetts.
authors: Lori
authors: L
authors: Lazdowsky
authors: Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Waltham, Massachusetts.
authors: Alyssa
authors: A
authors: LeBel
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications*; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications; D008385:Marijuana Smoking / Q000009:adverse effects*; D011605:Psychoses, Substance-Induced / Q000209:etiology*; D011618:Psychotic Disorders / Q000209:etiology*; D055815:Young Adult