Craniocerebral (brain) injury (long-term consequences)

Treatment.

Immature (stem) cells are implanted into a subarachnoid space of a patient via a lumbar puncture (a patent of RF № 2160113).The grafted cells release a variety of axonal growth-stimulating, neurotrophic factors, but also participate immediately in restoring affected nervous communications.

A patient firstly undergoes two cell transplantations at an interval of 10-to-14 days. The further treatment regimen is determined depend on changes in neurological status of the patient.

The treatment is conducted in the neurosurgical department.

Infectious safety.

The donor material is subjected to 3-level testing for infection (2 immunoenzyme analyses and 1 PCR examination).

Side effects.

Rise in temperature until 390 C, meningisms, nausea and vomiting are possible during first 2 days after a cell transplantation procedure. Those effects are reduced by the appropriate drug therapy. No long-term complications are registered.

Clinical effect.

The long-term stimulation of both regenerative and functional brain activity by grafted cells is capable of providing material neurological improvements.

CELL TRANSPLANTATION (CT) THERAPY IN TREATING SEVERE CONSEQUENCES OF TRAUMATIC BRAIN INJURY

Traumatic brain injury is a main cause of disability among young people. Low reparative abilities of adult nervous tissue strongly confined the possibilities of functional restoration of injured brain. Therefore, benefits from the therapeutic approaches based on applying neuroprotectors, antioxidants, hormones, as well as drugs improving brain blood flow, frequently unapparent in brain-injured patients.

The Central Nervous System (CNS) is the "immune-privileged" organ where there are substantial barriers to the development of immune processes directed against allogeneic donor cells. Therefore, when being grafted into CNS, immature (stem) cells survive, differentiate and function, thereby, ameliorating injury-related, neurological defects. Cell transplantation (CT) therapy, that is aimed directly to enhance reparative processes in CNS, undoubtedly opens new exciting opportunities in treatment of severe neurological disorders.

Both safe and clinical relevance of CT therapy for brain-injured patients have been assayed in our Center . A total of 56 patients (19 females and 37 males aged from 18 to 73 years) with severe consequences of brain injury in the form of a psychoorganic syndrome have been enrolled in the trial group, all of whom were refractory to conventional cure. Their time periods after trauma were not longer than 2 years. All patients had cystic adhesive arachnoiditis with the signs of both cerebral hemisphere atrophy and hydrocephaly. Twenty-three patients had subarachnoid cysts. Intracerebral cysts were revealed in 11 patients. Intractable generalized convulsive syndrome was noted in 10 cases. There was the association of intracranial hypertension with both intellect and focal organic brain disorders. Sixteen, 32 and 8 patients were cell-grafted into a subarachnoid space 1, 2 and 3 times, respectively. With CT treatment the patients demonstrated a detectable regress of their brain symptoms, as well as an appreciable decrease in their extrapyramid tonus. Discontinuance of epileptic seizures was noted in 4 cases. Those patients stopped entirely intake of anticonvulsive drugs within 3-to-4 months after treatment (follow-up time is 1.5 years). The remaining patients with an episyndrome reduced a dose of anticonvulsants by 2-to-3 fold. All CT-treated patients, without exception, felt burst of energy, rise in capacity of work and elevation of mood. At 1 year after CT treatment the regress of atrophic hydrocephaly was typically seen on magnetic resonance imaging (MRI) scan; the restoration of normal biorhythm was observed on ElectroEncephaloGram (EEG) . CT therapy enabled the patients to enhance greatly their functional capacities. CT therapy was found to be safe and well tolerated; no serious complications were noted.

The trial group was very heterogeneous in both clinical presentations and follow-up time periods. For this reason, we were unable to form a clinically comparable, the control group of patients. Nevertheless, the results of this investigation should be undoubtedly considered as very encouraging. They indicate an advisability of applying CT therapy in those cases when neurological defects are profound and their conventional cure is inefficient.

For more information see the publications .

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