Hemorrhagic stroke accounts for 10-20% of all incidences of stroke. It describes bleeding in the brain due to rupture of brain blood vessels. The disrupted blood flow to the brain results in the loss of essential neurological functions. The risk of hemorrhage increases with age. Current treatments target different aspects of the condition but fail to show substantial improvements in functional capacity and survival. Research continues in this direction to design a better treatment alternative. This blog focuses on regenerative medicine as the promising frontier for brain stroke treatment in India.
Causes of Hemorrhagic Stroke
The blood vessel rupture plays a central role in hemorrhagic stroke. Therefore, factors that negatively affect blood vessels are the primary causes of hemorrhagic stroke.
Hypertension: It increases pressure in vessels, leading to their remodeling and thus increasing their susceptibility to burst.
Cerebral Amyloid Angiopathy: It occurs in old age due to the build-up of amyloid proteins in vessels. The resultant loss of smooth muscles surrounding the vessels leads to the gradual weakening of the vessel wall.
Coagulopathy: Anticoagulation and antiplatelet medications are prescribed to individuals in case of specific medical issues. These medications elevate the risk of this disorder.
Additionally, high cholesterol, smoking, excessive alcohol consumption, and drugs such as cocaine, heroin, amphetamine, etc., also augment the possibility of hemorrhagic stroke.
Symptoms of Hemorrhagic Stroke
The hemorrhagic stroke causes bleeding in the brain, increasing intracranial pressure. Therefore, its symptoms manifest as headache, difficulty in speaking, weakness on one side of the body, and facial muscle weakness or paralysis. The progression of the disorder is typically rapid. The signs depend on the location and severity of the condition.
- Headache
- Vomiting
- Seizures
- Weakness on one or both sides of the body
- Difficulty in communication
- Visual loss in one or both eyes
- Unreactive pupil or impaired movement of eyes either upward or downward
- Loss of sensation, numbness, or tingling
- Impaired movement or balance
- Decreased level of consciousness or coma
Furthermore, droopy eyelids, slower heart rate, increased sensitivity to light, and stiffness in the neck are also present. The treatment at the earliest is recommended in cases of stroke and is often associated with better clinical outcomes. Thus, timely recognition of the signs of hemorrhagic stroke is crucial. To facilitate the same, a mnemonic has been created- BE FAST
- Balance: Loss of balance.
- Eyes: Visual loss in one or both eyes.
- Face: A droopy face or facial paralysis.
- Arm: During a stroke, they may not be able to lift one arm or show weakness in it.
- Speech: Difficulty in talking or slurring in speech.
- Time: In the presence of all the signs, call for help as soon as possible.
Stem Cell Therapy
The management of hemorrhagic stroke includes managing risk factors and halting the worsening of the condition. A few preventive strategies include controlling hypertension or regulating anticoagulation medications. Furthermore, anti-epileptic therapy and reduction of intracranial pressure are also a few other management methods. The outcomes of the surgical approach are also sub-optimal. The limitations of the available treatments have reoriented the medical field from the traditional treatment approach to regenerative medicine. Regenerative medicine addresses the drawbacks of the traditional approach of damage repair and restoring function.
Stem cell treatment is the focal point of regenerative medicine. It has become a feasible treatment option and has been employed in many disorders and shown positive results. Therefore, its application in hemorrhagic stroke treatment has also been attempted. Among the several types of stem cells, mesenchymal stem cells (MSCs) for stroke treatment have demonstrated significant results.
The Rationale Behind Stem Cell Treatment
Research has delineated the following mechanisms of stem cell therapy that act on stroke.
Neurogenesis: Stem cells can transform into neural cells and also promote brain neural cell proliferation. MSCs also augment the expression of growth-associated glycoprotein-43 (GAP-43) that promote neurogenesis. Additionally, many studies have suggested that MSCs can reorganize neural circuits in the brain.
Blood-brain Barrier: The blood-brain barrier protects the transfer of harmful pathogens or toxins to the brain. However, after a stroke, brain immune cells release matrix metalloproteinases that break down the barrier. It allows the movement of more immune cells and inflammatory mediators into the brain, leading to edema and high intracranial pressure. Stem cells reinforce the integrity of the barrier by decreasing the expression of metalloproteinases and increasing the expression of barrier proteins.
Neuroinflammation: Inflammation follows the blood vessel rupture and promotes the migration of immune cells. It leads to further deterioration of nervous tissue. Stem cells reduce the levels of pro-inflammatory cytokines and increase the levels of anti-inflammatory cytokines. MSCs induce the expression of TSG-6, a protein that alleviates the influx of immune cells.
Neuroprotection: Stem cells suppress the pathways that cause neuronal loss. MSCs increase the Akt and Bcl-2 levels, which are responsible for cell survival.
Angiogenesis: Blood vessel leakage is the primary cause of this disorder. Therefore, vessel repair and modeling are essential to prevent further leakage. Stem cells promote angiogenesis, the process of blood vessel formation and vascular stabilization. MSCs activate the Wnt signaling pathway, which is responsible for the proliferation and migration of vessel endothelial cells.
Is Stem Cell Therapy Good For Stroke Patients?
Many clinical trials have been conducted with stem cell treatment for hemorrhagic stroke.
- Chang et al. administered MSCs in patients with severe neurological deficits and monitored the outcomes after 60 months. The blood clot was reabsorbed 3 months post-treatment. Furthermore, the treatment exhibited a reduction in stroke and disability, along with improvements in the ability to perform daily tasks.
- Phase I/II randomized study by Tang et al. showed neuro-restoration and improvements in motor skills, levels of consciousness, and cognitive scores of patients receiving stem cell treatment.
Despite the source or dose of MSCs, the treatment showed improvements in functional outcomes up to 5 years after treatment. These clinical trials are evidence of positive results with stem cell treatment.
These trials also estimated if stem cells cause any adverse effects. However, each study reported a lack of adverse effects post-treatment, thus proving that stem cell treatment is suitable and safe for stroke patients.
Brain Stroke Patient Success Stories
Advantages of Stem cell Therapy
Non-surgical: Since administering stem cells doesn’t involve surgery, there is less need for hospitalization and less pain.
Long term Effects: Clinical studies revealed that patients maintained their post-treatment results for extended periods of time, eliminating the need for continuous stem cell transplantation.
Quality of Life: Following stem cell therapy, increase in functional ability helps people become less dependent on others, which improves their quality of life.
Conclusion
Hemorrhagic stroke is associated with low survival. The treatment options have limited effects on functional improvements. The pathogenesis of stroke requires a multi-faceted approach, which cannot be availed by the single treatments currently used in stroke management. Therefore, healthcare professionals and scientists are redirecting their efforts towards stem cell therapy. Research has exhibited the mechanisms of this treatment, while clinical trials have proved their potential in patients. The treatment is effective and does not cause any complications. The long-term follow-up has supported the prolonged benefits of the treatment. Advancells is forging a path to this cutting-edge therapy by providing high-quality stem cells. These stem cells are stringently tested and suitable for the best brain stroke treatment in India.
FAQs
Q – What are the signs of hemorrhagic stroke?
The stroke signs commonly include headache, facial paralysis, loss of sensation, coma, imbalance in posture or movement, stiffness in the neck, difficulty in speech, and paralysis in limbs.
Q – Why are stem cells better than conventional treatment options?
Stem cells address the lacunae in conventional therapies by repairing the damage. It restores the function of the organ or tissue, which is not possible in other treatment options.
Q – Is stem cell therapy safe?
Clinical trials have evaluated the safety of stem cell therapy and reported the absence of any complications arising from treatment. Thus, the early clinical trials have deemed the therapy safe.
Q – How do stem cells treat brain stroke?
Stem cells induce neurogenesis, alleviate neuroinflammation, boost angiogenesis, reinforce the blood-brain barrier, and confer neuroprotection, which effectively treat brain stroke.
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