UPDATED October 15, 2020 – A Brain stem injury can occur via blunt force trauma to the brain no matter the age at onset. A head injury can result from a substantial handicap to the individual who sustained the brain injury and may trigger numerous types of cognitive impairments like lack of focus, memory or other motor-neurological disorders such as ataxia, ALS, Spinal muscular atrophy or Parkinson’s Disease. A brain stem injury may also consist of any damage that’s vascular by nature and not by blunt force trauma event that directly caused or instigated the intracranial injury.
Etiology of Traumatic Brain Injury
Modern treatment options for head injuries are usually divided into two types, closed head injuries, and penetrating head injuries. Overlap for the two types does exist, and closed head injury treatments can be further segmented into mild, moderate, or severe/traumatic head injuries. A neurological injury is dissimilar from a traumatic brain injury (TBI) or stroke because an exterior force injures the brain in a damaging violent manner. TBI is an injury in the brain which is brought about by some the traumatic influence. TBI and brain damage can be caused by blows to the head (severe head trauma,) cerebral trauma, cranial penetration, or even violent trembling. Depending on the cause and severity of the trauma, the brain damage can be classified as serious, moderate or mild and damage from neurodegeneration can include, glial cells, neurons, endothelial cells, and Axonal Degeneration. 
Classifications of Traumatic Brain Injuries (TBI)
A TBI occurs after damage to the brain from external forces such as Impacts, rapid deceleration or acceleration, blast waves, or blunt force trauma. After such an incident, overall neurological impairment can be temporary or permanent depending on the severity of blunt force trauma to the head. The focus of this article will be to understand the signs, symptoms, and new treatment options for traumatic head injuries that occur after birth only. There are currently two subsets brain damage, including traumatic and non-traumatic (non-penetrating) brain injuries resulting from exposure to toxins, brain stroke, or viral infections. Most brain injuries are classified as either neurotrauma or central nervous system injuries that can affect cell signaling and neurotransmitters, which can lead to other neurodegenerative conditions like dementia. Recent medical studies also indicate that inflammatory and autoimmune processes are major factors process that lead patients from TBI events to eventual permanent loss of cognitive capabilities.
TBI is classified based on several factors including severity, causative forces, anatomical locations of the injury, and the mechanism. Mechanism-related injuries are either considered penetrating head injury or nonpenetrating/blunt/closed injury. An open or penetrating head injury happens when an object goes through the skull and breaches the outermost membrane of the brain known as dura mater.
Glasgow Coma Scale – GCS
Traumatic Brain injuries are classified into three categories, including mild, moderate, and severe. The most commonly used system around the world to classify TBI severity is known as The Glasgow Coma Scale (GCS). The GCS scale (3–15) grades a victim based on their level of consciousness, which is based on measuring motor, verbal, and eye-opening reactions. A brain injury with a GCS of 13 or above is considered mild, a head injury with a GCS score of 9–12 is deemed to be moderate, and any GCS score below eight is regarded as a severe head injury.
The GCS scale can also be changed after the victim is resuscitated, post-traumatic amnesia (PTA), or after recovering from the loss of consciousness (LOC). Other methods of classifying the severity of TBI include using neuroimaging scans from CT, MRI, or PET to measure brain swelling, diffuse injury, or focal lesions. A mild TBI is also commonly known as a concussion, but such an injury result in brain contusion or lead to trauma-induced paralysis.
Stem Cells used in Cases with Anoxic Brain Damage
Each region of the human brain and spinal cord possess various types of specialized cells. The Regen Center NeuroCell protocol works through usage of adult MSC+ cells, for specific regions that help in the development of the central nervous system (CNS).
The goal of our Neural cell replacement therapy and spinal cord injuries is to target the damaged areas and then to repair dead or diseased progenitor cells that are found in the neurogenic region.
Initial symptoms and signs of the TBI could consist of:
- Blurred vision
- Memory loss
- Loss of consciousness
Focal vs. Diffuse Brain Injuries
Using a CT scan, TBI lesions can also be classified by their pathological features, including extra-axial or intra-axial. Extra-axial lesions refer to injuries that occur outside of the brain but inside the skull while intra-axial lesions refer to injuries that happen inside the brain tissue. Results from these injuries can be diffuse or focal or both depending on the severity.
Warning Symptoms After Traumatic Brain Injury
Symptoms of Diffuse injuries include edema (brain swelling) and destruction to white matter tracts, cerebral hemispheres, and axons (diffuse axonal). Focal injuries, on the other hand, occur mostly in the orbitofrontal cortex and temporal lobes resulting in behavioral changes, problems with decision-making, language difficulties, and decision-making skills.
Focal lesions such as Hematomas result in the rapid collections of blood around the brain and can result in an Intracerebral hemorrhage stroke,subdural hematoma (bleeding between arachnoid mater & dura), subarachnoid hemorrhage (bleeding between arachnoid membrane and the pia mater), epidural hematoma (bleeding into dura matter) or intraventricular hemorrhage (bleeding in ventricles).
Therapeutic Treatment for TBI after Blunt Force Trauma
For optimal results, early intervention is the key to recovering from brain injuries that affected the nervous system. Response during the first 60 minutes after injury i.e., “golden hour” is recommended. For most patients, treatment options depend on the age of injury and stage of recovery. Patients in the acute phase are looking to stabilize the condition from progressing using a combination of surgery and physical rehabilitation.
For Acute stages of TBI or injuries that occurred paying sports, maintaining proper blood flow to the brain is critical to avoid brain herniation and seizures. In this stage, Decompressive craniectomy (DC) can be used to relieve intracranial pressure along with hyperbaric oxygen therapies to ensure proper oxygen supplies are maintained. Neuroimaging from brain scans are also used to better target therapies using analgesics, Sedatives, paralytic agents and sometimes hypertonic saline to reduce swelling, regulate body temperature, hypotension, reduce risk of heart failure or avoid electrolyte imbalances.
Patients with TBI are at a much higher risk of complications and adverse side effects requiring contacting monitoring for signs of deterioration or loss of consciousness. Other complications of Traumatic Brain Injuries include pulmonary edema and cardiac arrhythmia. In chronic stages of TBI, Pharmacological based treatments can be used to treat behavioral (psychiatric issues) and post-traumatic epilepsy.
Reverse Damage From Brain Injury – Stop Concussions
Brain Stem cells transplantation into the affected region might be beneficial in certain circumstances wherein the damage is not too severe and has occurred relatively recently. (from 6 months up to two years after initial Injury) The neural stem cell implantation purpose would be to attempt to restore signal functions with comparable properties. In situations of TBI, numerous cell kinds are required (glial, neuronal, vascular, endothelial ) to regenerate the complex functions of largely damaged regions of the brain.
Neural Cell Replacement Therapy
In much more severe instances of traumatic brain-related injuries such as Chronic traumatic encephalopathy (CTE), some complications can be fatal. While the rigorousness of the TBI
differs broadly, the consequences of it, in the long run, are frequently devastating and life-changing. TBI is typically very sudden, and early intervention is the key to a full recovery. The physical, non-congenital harm towards the brain by an external force may permanently or temporarily disrupt regular brain function.  Brain characteristics and functions that may be affected include temporary or permanent loss of consciousness, speech, language, memory, character, mobility, joint pain with lupus, peripheral neuropathy and recognition of other people. Since the brain controls all bodily functions, any harm towards the brain,(neurons) no matter how little or severe it is, can impair physical and psychological activity.
TBI CLINICAL TREATMENT PRECAUTIONS & RISKSThe Regeneration Center cannot accept patients with severe brain injuries or blunt force trauma accidents that are over 24 months old. All molecular neurodegenerative disease cases will also require physical ability to travel to Bangkok for the 2-3 week protocol.
Treatment Guidelines For Brain Injuries
Number of Sessions: Multiple Infusions of MSC+ cells from Bone Marrow (Autologous) or Allogeneic cells combined with exosomes, neural progenitor cells, fibroblast growth factors, cytokines or chemokines to allow for higher survival rates of transplanted cells per treatment stage. The types of cellular infusions vary based on patient needs, but for most acute brain stem injuries the goal of treatment is to help reduce systemic neuroinflammation, promote faster recovery of any lost cognitive function through the process of neurogenesis. Our cell therapeutic delivery systems are safe and can be administered via Stereotactic-guided delivery, inhalation therapy via micro-nebulized mesenchymal cells, Intravenous Drip, or Intrathecally.
Clinical Rehabilitation Post-Treatment: Physical Rehabilitation therapy in Bangkok is optional, depending on the patients’ travel/time constraints. Complete physical rehabilitation post-therapy and can be provided upon request for 2-4 hours per day and up to 5 days per week. Medical visas and extended stay accommodations for the patient and family can also be included upon request.
Costs Related to Treating Brain Injuries with Stem Cells & Physical Rehab
Our treatments protocol for Traumatic Brain Injuries will require a minimum of 14-21 nights in Bangkok. Due to the significant differences in brain injury treatment requests, our medical team will need to qualify the potential candidate for treatment. Upon acceptance, a detailed treatment plan will be provided and include the specifics of the treatment plan that will include: total number nights required along with the total medical related expenses including cell extraction, enrichment, and infusions (excluding accommodations or flights). To begin the qualification process for multi-stage TBI neural stem cell transplants, please prepare your recent medical records such as recent Brain MRI’s, CT Scan (Preferred) or PET Scans and contact us today.
Published Clinical Citations
 ^ Dharmasaroja, Permphan. 2008. Bone marrow-derived mesenchymal stem cells for the treatment of ischemic stroke. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, no. 1 (November 18). doi:10.1016/j.jocn.2008.05.006. https://www.ncbi.nlm.nih.gov/pubmed/19017556
 ^ Dinh, Michael M, Kendall Bein, Susan Roncal, Christopher M Byrne, Jeffrey Petchell, and Jeffrey Brennan. 2012. Redefining the golden hour for severe head injury in an urban setting: the effect of prehospital arrival times on patient outcomes. Injury, no. 5 (February 14). doi:10.1016/j.injury.2012.01.011. https://www.ncbi.nlm.nih.gov/pubmed/22336130
 ^ Kunkanjanawan, Tanut, Parinya Noisa, and Rangsun Parnpai. Modeling neurological disorders by human induced pluripotent stem cells in Thailand Journal of biomedicine & biotechnology (November 24). doi:10.1155/2011/350131. https://www.ncbi.nlm.nih.gov/pubmed/22162635
 ^ Prè, Deborah, Michael W Nestor, Andrew A Sproul, Samson Jacob, Peter Koppensteiner, Vorapin Chinchalongporn, Matthew Zimmer, Ai Yamamoto, Scott A Noggle, and Ottavio Arancio. 2014. A time course analysis of the electrophysiological properties of neurons differentiated from human induced pluripotent stem cells (iPSCs). PloS one, no. 7 (July 29). doi:10.1371/journal.pone.0103418. https://www.ncbi.nlm.nih.gov/pubmed/25072157
 ^ Yang, Yongxiang, Yuqin Ye, Xinhong Su, Jun He, Wei Bai, and Xiaosheng He. 2017. MSCs-Derived Exosomes and Neuroinflammation, Neurogenesis and Therapy of Traumatic Brain Injury. Frontiers in cellular neuroscience (February 28). doi:10.3389/fncel.2017.00055. https://www.ncbi.nlm.nih.gov/pubmed/28293177