UPDATED September 01, 2020 – Stroke is a term to describe an interruption of blood flow and oxygen to parts of the brains. Once the gray matter in brain cell stops getting enough oxygen and nutrients needed to survive, cell death begins. In the human mind, Grey matter contains the majority of neuronal cell bodies and are responsible for managing many functions such as emotions, muscle control, hearing, decision making, sensory perceptions, memory, speech, and self-control.
Causes of Brain Strokes
There are two main types and causes of brain strokes. Sudden blocking of arteries can cause acute ischemic strokes or damage to blood vessels resulting in bursting or leaks can cause hemorrhagic strokes and cryptogenic strokes. Over 80-85% of strokes are ischemic, and about 10-15% of strokes are hemorrhagic. Strokes caused by bleeding cause more damage and are more challenging to treat than ischemic. Some patients may have a very short disruption to the brain known as a transient ischemic attack (TIA) or “mini-strokes,” but these type of strokes are not as dangerous and might not permanent brain damage.
A stroke caused by blockage of the blood vessels that supply blood to our brain is known as an ischemic stroke and is generally the most common type of strokes we treat at the regeneration Centre of Thailand. There are two main classifications for ischemic strokes.
- A thrombotic stroke occurs due to blood clots in the thrombus — this type of blood clot forms in the peripheral vascular system arteries that provide blood to the brain. Thrombus blood clots can be caused by multiple factors including atherosclerosis or plaque built up in arteries resulting in reduced blood flow to the brain.
- Embolic strokes that occur when debris or a blood clot travels to the brain and gets stuck in the narrow arteries of the brain. Blood clots in the brain are called embolus, and theses clots usually form in the heart before they travel to the brain.
Acute Ischemic strokes are caused by blood clots or stenosis (narrowing of the blood arteries.) Stenosis if often caused by poor habits that lead to atherosclerosis causing thick artery walls, hardening, and also a loss of elasticity, which leads to decreasing blood flow. Other factors include a family history of strokes/genetics, dementia, atrial fibrillation, heart disease, Congestive heart failure, diabetes, high cholesterol, and Smoking.. DNA tests are now available for genetic predisposition to strokes.
A rupture in the blood vessels usually causes a hemorrhagic stroke. There are several causes for a hemorrhagic stroke, including aneurysms, weak spots on the arterial walls, and Hypertension, or High blood pressure. There are two main types of hemorrhagic strokes.
- Intracerebral hemorrhaging occurs when the brain blood vessel leaks blood inside the brain
- Subarachnoid hemorrhaging happen when bleeding brain membranes leak into the fluid-filled areas surrounding the brain.
Warning Signs & Symptoms of Strokes
The severity of the physical damage caused by a stroke depends on how much blood flow was restricted and for how long. Some visible and noticeable consequences of impaired brain function are:
- Paralysis of the limbs
- Loss of vision or hearing
- Problems with speaking
- Unable to walk properly
For most people, the symptoms of a stroke typically start without prior warning and can last from just a few seconds to a few minutes. Some fortunate patients recover quickly without further damage or issues buy for many this is not the case. The symptoms and warning signs often depend on which area of the brain gets affected. Severe strokes affect larger regions in the brain; thus, more physical functions are likely lost and can result in orthopedic injuries to knees, hips, hands, or shoulders due to falls.
Currently, the only traditional treatments of ischemic strokes require restoration of proper blood flow back into the affected area by using a mechanical device or thrombolytics that physically removes any brain clots. The use of thrombolytics is very beneficial if introduced a few hours after the patient displays stroke symptoms but not very useful; the longer a patient waits. This means that only a few stroke patients can take advantage of this therapy due to the timing requirements.
Risk Factors for Strokes
Several factors can increase or reduce a person’s risk of getting strokes. Some controllable risk factors for strokes include:
- Lack of exercise
- Being overweight or obese
- Alcohol abuse
- Cigarette smoking & secondhand smoke
- Use of drugs or unprescribed medications
- Adverse reaction to Hormones or hormone replacement
Other medical related risk factors include:
- Chronic Hypertension
- Autoimmune antibody-mediated central nervous system
- Heart disease, previous heart attacks, heart infections or cardiac arrhythmia
- Lung disease
- High cholesterol
- Obstructive sleep apnea
Women and Cryptogenic Strokes
Brain stroke kills twice as many women per year as breast cancer. Strokes are currently the third leading cause of death for women across the world, and for this reason, women should take the necessary steps by understanding the factors and making changes to reduce overall risk factors.
Some female-specific risk factors for having brain strokes include:
- Hormone replacement therapy (HRT)
- Taking hormone contraceptives
- Started Menopause before the age of forty-five
- Started Menstruation before the age of ten
- Low levels dehydroepiandrosterone (DHEAS) a hormone
- Having other health problems, including migraines, UC, Fibromyalgia, or lupus. A history of having complications during pregnancy an also indicate the women might be a higher stroke risk. These complications can include hypertension and gestational diabetes during or after pregnancy.
To diagnose a stroke, a physician usually examines the patients’ pulse and breathing patterns. Among other things, blood pressure, frequency of heartbeat, and blood sugar are measured. The person affected and the relatives or relatives of the patient are asked about the history of the stroke patient, symptoms, and risk factors. It is especially helpful if the date of the first occurrence is known. A Physical examination can be used to detect paralysis, impaired consciousness, speech ability, as well as speech comprehension and emotional disorders. Unconscious patients may receive oxygen treatment via a tube in the trachea ( intubation ) along with IV bags for fluid and medications to be delivered by a hospitals stroke unit.
At the hospital, nerve function tests can help provide clues as to which parts of the brain are affected by the stroke and how severe the damage is. Blood collection and testing provide information on, among other things, blood counts, blood clotting, inflammatory parameters, and risk factors such as elevated cholesterol or blood glucose levels. The medical team can then use imaging techniques such as CT Scan (computed tomography ) or MRI scan (magnetic resonance tomography) to scrutinize the patient’s brain. The radiology scans are especially helpful to diagnose if the patient has an ischemic or hemorrhagic stroke is present, detect circulatory disorders or existing cerebral hemorrhages. In addition, the cerebral vessels can be also be visualized by a CT angiography to detect blockages.
Other tests used to check the cause of the stoke, brain vessels affected by arteriosclerosis, narrowing, or thrombosis includes ultrasound or duplex sonogram. Carotid arteries are also checked for permeability and can be visualized using contrast medium on CT or MRI scan. To detect cardiac arrhythmias, an electrocardiogram (ECG) is used.
Treatments for Brain Strokes
Treatment for stroke depends on what type of stroke it is and what the underlying cause is. For ischemic & cryptogenic strokes, doctors need to act quickly to restore blood flow to the brain and avoid further brain damage.
Treatment Protocol for Ischemic Strokes
Some medications for ischemic strokes can be used to try to break the clots inside the veins and must be given a few hours after a stroke.
- IV (Intravenous injections) of alteplase or tPA (tissue plasminogen activator) can be delivered through veins in the arm. These stroke medications can help restores proper blood flow by dissolving any blood clots and help patients recover faster
- Alteplase injections – Some patients with bleeding in the brain might not be good candidates for tPA or alteplase injections.
- Doctors can also perform, intra-arterial thrombolysis procedure using a catheter and send it to the brain area and deliver tissue plasminogen activator directly in the field of the stroke.
- A brain clot can also be removed using a stent retriever and is particularly beneficial for patients with large clots that don’t respond well to tPA.
- Endovascular therapy uses microcatheters inserted into the blood clot from the groin or the arms.
- Carotid endarterectomy surgery can help removes plaque from arteries. In the Carotid endarterectomy procedure, a surgeon makes a tiny incision in the front of the neck to expose the carotid artery and removes any plaque that is blocking the carotid artery then closed using a skin graft. Carotid endarterectomies can help reduce the risk of additional ischemic strokes but are risky for some patients, especially those with heart disease or other conditions like rheumatoid arthritis.
- Stents & Angioplasty surgery also use the carotid arteries. A balloon device is inserted in the carotid then inflated to help expand the narrowed artery or support the vessels
Treatment for Hemorrhagic Strokes
The goal of hemorrhagic stroke treatment is to control/stop the bleeding and reducing any extra pressure on the brain. Medications for Hemorrhagic strokes include warfarin (Jantoven, Coumadin,) anti-platelet medications such as Plavix (clopidogrel) to help prevent blood clots. Note anti-clotting medications and some blood thinners can conflict with stem cell therapy. Other medicines for Hemorrhagic strokes are used lower intracranial pressure, lower blood pressure, prevent seizures, or prevent vasospasm.
- Surgical blood vessel repair can also be used to treat blood vessel abnormalities caused by hemorrhagic strokes. This procedure is done after an aneurysm, stroke, arteriovenous malformation (AVM) or any other types of vascular malformations that are caused by hemorrhagic stroke.
- Surgical clippings are tiny clamp placed at the bottom of the aneurysm, to try to stop blood from flowing into it. These clamps also keep the aneurysm from re-bleeding or bursting.
- Endovascular embolization or “Coiling” can be done via a catheter to fill the aneurysm, which then blocks any blood flow to the aneurysm and helps the blood to clot as it usually does. Surgical AVM removal can be used to reduce any risk of rupture and also lowers the risk of having another hemorrhagic stroke. Due to the risks associated with AVM removal surgery, highly focused radiation known as Stereotactic radiosurgery is used as a minimally invasive treatment to repair vascular malformations.
Stents for Stroke Patients
Stem Cell Treatment for Strokes
Stem cell treatment for Brain Strokes offers an effective alternative medical treatment to target and repair the brain tissue damage to try and recover lost functions along with measurable neurological improvements.
Traditional treatments for stroke patients can only manage the symptoms but cannot do much to try to repair the damaged tissue or replace the dead cells. Exosome therapy using neural stem cell growth factors help target the underlying cause of the patient’s injury and not just mask the symptoms. Neural stem cell transplants are safe and painless to inject and have shown to survive transplantation and begin differentiating into new neurons in the patients brain tissue. In addition to the replacement of damaged cells, replacement therapy can also induce endogenous neural precursors that help boost the brain’s’ structural neuroplasticity, regulate pro-inflammatory cytokines and the neuronal apoptotic death process. To learn about stem cells visit here.
Reverse Stroke Damage Naturally
The damage to the brain is usually done when the proper flow of oxygen and blood is stopped or blocked for some time. It is critical to get an immediate medical intervention to try to restore the normal circulation of blood and oxygen to the brain and avoid long term damage. We typically recommend having active treatments like neural stem cell replacement as quickly as possible following a stroke to avoid the chances of lesions forming which lead to scar tissue that cannot be repaired after a certain length of time causing permanent paralysis with peripheral neuropathic pain in ischemic stroke patients
Improvements after Stroke Therapy
Neural stem cell therapy uses the paracrine cell signaling method to target the damaged part of the brain’s neural circuitry that controls motor functions. The cells are first enhanced in our stem cell lab then injected intravenously, via a proprietary stem cell nebulizer treatment to deliver cells near the motor neuron tracts close to the lesions in an attempt to promote regeneration and repair through the section of Cytokines and nerve growth factors. The benefits are gradual; however, most patients show immediate improvements after the first or second infusions and continue to show improvement 3-6 months post-therapy. The results are permanent but will require consistent physical and speech rehabilitation after treatment to allow the brain to return to proper function, especially for cases with cerebral hemorrhaging and cerebral infarction.
Other noticeable Improvements of Stem cell therapy for Strokes include:
- Improved physical coordination and posture
- Improved speech with decreased symptoms of facial palsy
- Improved lower body movements
- Ability to stand unassisted
- Improved hand-eye coordination with improvements in fine motor skills especially with hands, fingers, and toes
- Increase in overall muscle strength
- Improvements in overall cardiovascular health & blood circulation
- Reduction in muscle tension
- Improved sensations in face and limbs
Stem cells are a breakthrough technology but do have limitations. Based on research and experiences, the most successful patients’ recoveries happen for patients who start intervention treatment very early after the incident. Lack of oxygen to the brain can cause rapid damage and failure to other vital organs. If you or a loved one are unable to get stem cell therapy quickly after a stroke we recommend daily use of a hyperbaric oxygen chambers, External counterpulsation therapy (ECP), pulsed electromagnetic therapy (PEMFT) to areas on the back of the patients head, neural growth factors,nutritional iv injections and/or periodic acceleration therapy (pGz).
TREATMENT PRECAUTIONS & RISKSPlease Note stem cell therapies for strokes are not effective for all cases. Treatment brain injuries, cerebrovascular insults (CVI), cerebrovascular accidents (CVA) such as Strokes depends on the age of diagnosis and severity. Patients with undiagnosed complications, blood clotting disorders, heart failure, cerebrovascular accident related complications or travel limitations will not qualify.
Stroke Cell Therapy Overview
A Stem cell-based stroke protocol offers great potential to restore physical functions after stroke. Neural stem cell transplantation can use used to replaced damaged or dead neurons and promote neurogenesis by modulating inflammation, axonal plasticity, remyelination, angiogenesis providing neuroprotection for existing cells. The enhanced brain stem cell protocol for the treatment of neurological conditions such as SMA, Traumatic brain injuries, Parkinson’s, ALS, Motor Neuron Disease and ataxia have been optimized for therapeutic benefits and minimize risks associated with stem cell treatments. The strength and scope of any treatment will depend primarily on the patient current physical needs. The stroke treatment protocol will require 12 – 17 in Bangkok.
Physical & Speech Rehab After Treatment
Physical and Speech Rehabilitation is highly recommended after a stroke treatment and can be provided at a local hotel facility upon request. We can also assist in finding certified physical or speech rehabilitation with an accredited therapist in your home country depending on where you live. Medical visas and accommodations for an extended stay at serviced apartments are provided upon request.
Revised Stroke Treatment Guidelines for 2020
Due to varying degrees of severity, our medical team will need to review the patients’ medical records and diagnostic imaging results. Once the medical review is complete, we can know if the patient is a good candidate or not and provide a fixed cost for the entire treatment. To help us make an accurate assessment and provide a detailed treatment plan, our medical staff will need to review the recent medical records, including any imaging results from Brain radiology scans. (Test Results less than three months old are required for treatment evaluation)
To begin the pre-qualification process for our multi-stage stroke treatment, please contact us today.
Published Clinical Citations
 ^ Bandasak, Ratanaporn, Kulaya Narksawat, Chanpong Tangkanakul, Yotin Chinvarun, and Sukhontha Siri. 2011. Association between hypertension and stroke among young Thai adults in Bangkok, Thailand. The Southeast Asian journal of tropical medicine and public health, no. 5. https://www.ncbi.nlm.nih.gov/pubmed/22299451
 ^ Nilanont, Yongchai, Samart Nidhinandana, Nijasri C Suwanwela, Suchat Hanchaiphiboolkul, Taksin Pimpak, Pyatat Tatsanavivat, Gustavo Saposnik, and Niphon Poungvarin. 2013. Quality of acute ischemic stroke care in Thailand: a prospective multicenter countrywide cohort study. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, no. 2 (January 8). doi:10.1016/j.jstrokecerebrovasdis.2012.12.001. https://www.ncbi.nlm.nih.gov/pubmed/23305673
 ^ 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
 ^ Hao, Lei, Zhongmin Zou, Hong Tian, Yubo Zhang, Huchuan Zhou, and Lei Liu. 2014. Stem cell-based therapies for ischemic stroke. BioMed research international (February 26). doi:10.1155/2014/468748. https://www.ncbi.nlm.nih.gov/pubmed/24719869