Stem Cell Therapy for Brain Injury in India

Last Modified: July 21, 2020  |   Created on: December 8, 2019
Cell Therapy

At a glance:

  • The cost of stem cell treatment for brain damage in India is highly affordable, ranging from USD 7500 – 12000.
  • Traumatic brain injury is a major cause of human mortality and morbidity worldwide. 
  • The currently used therapeutic approaches for treatment of brain injury and related neurological effects is not satisfactory. 
  • Stem cell therapy has shown great potential for repairing brain damage and improving the condition by providing symptomatic relief. 
  • Stem cell therapy in combination with rehabilitation and conventional treatment methods can help restore the lost functions following a traumatic brain injury. 

For precise quotes and a detailed treatment plan, send your reports at care@lyfboat.com

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What is a head injury?

Head injury, known as Traumatic Brain Injury, is a nondegenerative medical condition that causes damage to the brain and affects the normal brain functions. It can lead to permanent or temporary impairment of physical, cognitive, psychological and emotional functions.

According to the Centre for Disease Control (CDC), a traumatic brain injury is “caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain”. However, all types of blows or jolts to the head do not result in a brain injury. In a TBI, complications are caused due to a break in blood brain barrier (BBB), extensive inflammation, diffuse axonal (neuronal) injury, and neurodegenerative lesions in the brain.

The extent of damage from a TBI can be mild, in which there is a small disruption in mental status or consciousness, moderate and severe, involving an extended period of loss of consciousness, coma, amnesia or death after the trauma.

What are the types of brain injury and damage that occurs?

Traumatic brain injuries can be defined as open (penetrating) or closed (or non-penetrating). In a closed head injury, the brain and the skull remains intact after the physical impact of an outside force, whereas in an open head Injury, a sharp item may penetrate or break open the skull and enter the brain. Other types of head injuries include:

Diffuse axonal injury

A diffuse axonal injury (sheer injury) is an injury to the brain that is caused by intense shaking or strong rotation of the head (such as shaken baby syndrome) or by rotational forces during a car accident. It doesn’t lead to bleeding but causes damage to the brain cells which results in gradual loss of axons (neural cells) and their functions. It can also cause swelling in the brain, which leads to further damage. Although it isn’t as visible from outside as with other forms of brain injury, diffuse axonal injury is known to be one of the most dangerous types of head injuries that can lead to permanent brain damage and even death.

Hematoma

A hematoma is a blood clot that occurs within the brain or on its surface. It may be referred to a collection or clotting of blood outside the blood vessels. They can occur anywhere in the brain. Hematoma can be very serious as clotting can increase the pressure the skull. This may cause loss of consciousness or result in permanent brain damage.
Types –

  • An epidural hematoma occurs when blood collects between the dura mater (the protective covering of the brain) and inside of the skull.
  • A subdural hematoma occurs when blood collects between the dura mater and the arachnoid layer (located directly on the surface of the brain).

Hemorrhage

A brain hemorrhage is uncontrolled bleeding in the brain. It can be –

  • Intracerebral hemorrhage (ICH): The bleeding occurs within the brain tissue and may be associated with other brain injuries, such as contusions. Depending on the size and location of the hemorrhage the doctor can determine if it needs to be removed surgically.
  • Subarachnoid hemorrhage: This occurs when there is bleeding in the space around the brain or bleeding into the subarachnoid space. It is commonly after a TBI and appears as diffuse blood spreading thinly over the surface of the brain. Most cases of subarachnoid hemorrhages related to head trauma are usually mild. However, it can lead to a condition called hydrocephalus, accumulation of excessive fluid in the brain.

Subarachnoid hemorrhages may cause headaches and vomiting while the severity of intracerebral hemorrhage depends on the amount of bleeding there is and over time it results in pressure buildup.

Concussion

A concussion occurs due to an impact or blow to the head and is severe enough to cause brain injury. It can result when a person’s brain hits against the hard walls of the skull due to the forces of sudden acceleration and deceleration. Generally, the loss of function related to a concussion is temporary, but repeated concussions may eventually lead to a permanent damage.

Contusion

A cerebral contusion is referred to bruising – bleeding of the brain tissue. Under a microscope, cerebral contusions seem comparable to bruises that occur in other parts of the body. It includes the areas of injured or swollen brain tissue mixed with blood which leaked out of the blood vessels due to the blow. Contusions most commonly occur on the base of the front parts of the brain, but it can occur in other places too.

Edema

A brain injury may lead to edema or swelling. Most injuries can cause swelling of the surrounding tissues in the affected area, but it becomes more serious when this occurs in the brain. As the skull can’t stretch or mold to accommodate the swelling, pressure starts to build up within the brain, resulting in pressing of the brain against the skull.

Skull fracture

Unlike many other bones in the body, the skull doesn’t have soft inner part called bone marrow. This makes the skull very hard or strong and difficult to break. When the skull breaks, it is unable to absorb the impact of a blow and chances are that there will also be damage to the brain.
Depressed skull fractures occur when the bone presses on or into the brain. They may require surgical intervention and the damage caused by a depressed skull fracture depends on the part of the brain affected and also whether it is accompanied by an associated diffuse brain injury.

What are the causes of brain injury?

The most common causes of a traumatic injury are:

  • Falls: Falling from an elevation, high bed, ladder, the stairs, in the bath and other heights are the most common reasons for a traumatic brain injury overall. It is particularly the case in older adults and young children.
  • Motor Vehicle Accidents: This is also a common cause of traumatic brain injury. An accident from a vehicle involving a pedestrian can result in a head injury.
  • Gunshot Wounds or injury from military installation or combats: Injuries from firearm shots and explosive blasts can lead to traumatic brain injury in active-duty military personnel.
  • Explosive blasts: If a person has been present during explosive blasts, the pressure wave passing through his/her head may significantly affect the brain function. Shrapnel, falls and bodily collisions with other objects, penetrating wounds, severe blows to the head.
  • Assaults: Domestic violence or other form of physical assaults can also cause TBI.
  • Sports/Recreation Injuries: contact sports such as soccer, boxing, football, hockey, baseball, lacrosse can cause a head injury. High-impact or extreme sport activities can also lead to traumatic brain injuries and are more common in youth.

In children – 

  • Child abuse
  • Abusive Head Trauma or ‘Shaken baby syndrome’ in infants may cause traumatic brain injury due to violent shaking.
  • Fall from heights

How can Lyfboat assist you getting Stem cell treatment for Brain injury in India?

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What are the symptoms?

A TBI or head injury can lead to a variety of physical and neurological symptoms in the patient. The signs and symptoms of head injury may vary depending on the severity of the trauma. Some of these signs may appear immediately after the injury, while others may be seen a few days or weeks later.

People with mild TBI show signs for- 

  • Loss of consciousness
  • Headache
  • Nausea or vomiting
  • Fatigue
  • Loss of balance

Sensory and cognitive issues 

  • Blurred vision
  • Ringing in the ears
  • Unusual or bad taste in the mouth
  • Changes in the ability to smell
  • Memory and Concentration problems
  • Mood swings or changes

People with moderate to severe TBI show all the signs of mild traumatic injury and also the following –
Physical symptoms include: 

  • Severe or persistent headache
  • Blurred vision
  • Loss of consciousness (from several minutes to hours)
  • Repeated vomiting or feeling of nausea
  • Seizures or convulsions
  • Dilated pupils of one or both eyes
  • Clear fluids or blood coming out from the nose or ears
  • Sensitivity to sound and light
  • Feeling of weakness or numbness in fingers and toes
  • Lack of coordination

Mental or cognitive symptoms include: 

  • Depression or anxiousness and profound confusion
  • Agitation or an unusual behavior
  • Slurring of speech
  • Problems with memory and concentration
  • Coma and other form of unconsciousness

How is brain injury diagnosed?

  • Cardiac and pulmonary function tests
  • Physical examination of the entire body
  • A complete neurological examination including the Glasgow Coma Scale (GCS). It is a 15-point test that can help the doctor to assess the initial level of a brain injury by checking a patient’s ability to follow directions, move their eyes and limbs as well as the coherence of speech.
  • Other than this, test to check the ability of the pupils to dilate when exposed to bright light is also done. People with a large mass of lesion or high intracranial pressure (ICP), may have one or both pupils that are blown or wide. Also, brainstem reflexes such as gagging and corneal (blink) tests are also conducted.

Imaging test

  • A computed tomography scan (CT scan) is the gold standard of radiological test for a TBI patient. It is not only easy to perform, but also proficient in detecting the presence of blood and fractures, the two most crucial lesions for identifications in medical trauma cases.
  • X-ray of the skull is also recommended by some doctors to evaluate patients who show only mild neurological dysfunction. However, CT scanning is a more accurate test and the routine use of skull x-rays for TBI patients is usually declined.
  • Magnetic resonance imaging (MRI) is done after the patient has been stabilized as it is difficult to move an acute trauma patient for MRI. The test may show the presence of lesions that were not detected by the CT scan.

Intracranial pressure monitor
Swelling in the brain tissue due to a head injury can result in increased pressure inside the skull. This can cause additional damage to the brain. The pressure is checked by inserting a probe in the skull.

What are the conventional methods of treatment of traumatic brain injury?

The treatment strategy for brain injuries is based on the type and severity of the injury that has occurred.

In case of minor head injuries, there are usually no symptoms besides pain at the site of the injury. The doctor often suggests taking acetaminophen (Tylenol) for the pain in such cases.

The experts advised against taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or aspirin as these can make bleeding worse. If there is an open cut, the doctor may use sutures or staples to sew it and then cover it with a bandage to protect the injury site.

However, it is important to keep in mind that even if the injury seems to be minor, you should monitor the condition for other symptoms and to make sure it doesn’t get worse. If any new or worsening symptoms appear, contact the doctor or visit the hospital to get it checked.

When the head injury is serious, patients usually need to be hospitalized. The treatment plan is determined after careful evaluation of the condition through tests. Depending on diagnosis, treatment may include:

Medications
These are to limit the secondary damage to the brain immediately after an injury. Medications for traumatic brain injury patient include:

  • Diuretics: to reduce the amount of fluid in tissues as well as increase the urine output. Diuretics are given intravenously to people who had a traumatic brain injury and it helps in reducing the pressure inside the brain.
  • Anti-seizure drugs: People with moderate to severe traumatic brain injury are at risk of may have seizures in the first week after the injury. The anti-seizure drugs can be given during the first week to avoid any further brain damage which might be caused due to a seizure. However, anti-seizure treatment is continued only if seizures occur.
  • Coma-inducing drugs: These drugs are sometimes used to put people into temporary comas because the brain requires less oxygen to function when comatose. It is particularly helpful when blood vessels get compressed by increased pressure in the brain and are unable to supply normal amounts of nutrients and oxygen to the brain cells.

Surgery
Emergency surgery may be required to minimize any additional damage to the brain tissues. Surgical procedure may be done to:

Remove clotted blood known as hematomas. Bleeding outside or within the brain can increase pressure on the brain and damage brain tissue.

Repair skull fractures. Surgery may be needed in case of severe skull fractures or to remove pieces of skull from the brain.

Manage bleeding in the brain. Brain injuries can cause bleeding within the brain and it may require surgery to stop the bleeding.

Open a window in the skull. Surgery may be performed to provide relief from the excessive pressure inside the skull by draining out the accumulated cerebral spinal fluid (CSF) or to create a window in the skull to provide more space for swollen tissues. The surgery to drain out CSF from brain and divert fluid to other body part is known as VP shunt surgery.

Almost all patients with head injury are known to benefit from rehabilitation and it also assists in the long-term recovery. This may include the following therapies:

  • Physical therapy
  • Occupational therapy
  • Speech and language therapy
  • Psychological support

How does stem cell therapy work for treatment of traumatic brain injury?

Stem cell therapy is a regenerative medicine technique, which involves the use of stem cells for their reparative response towards diseased, dysfunctional or injured tissue in the body. Stem cells are the progenitor cells that possess the unique abilities of self-renewal and differentiation into specialized cells.

Adult stem cells can be found in several areas in the body, such as muscles, skin and bone marrow. When the need for repair or generation of new tissues arises, they get activated and become capable of developing into cells with specialized functions such as blood cells, muscle cells or nerve cells. These cells are also capable of stimulating regeneration and repair of the cells in the damaged tissue.

Stem cell therapy for brain injury involves transplantation of these cells into the patient. The stem cells then migrate to the damaged areas of the brain and start the repair process directly or indirectly. After transplantation, they can start to multiply and differentiate to directly replace the dead or damaged brain cells. The transplanted stem cells may also indirectly repair and restore the cells in damaged tissue through paracrine mechanisms.

This includes release of various kinds of cytokines and growth factors that stimulate the endogenous cells and prevent further damage of brain cells. The cells also promote the development of new blood vessels, known as angiogenesis, which help in increasing the supply of blood and oxygen to the brain. This also helps in initiating generation of new axons/neural cells. All these processes together help in re-establishing the neuronal networks and promote formation of new communication channels. This further leads to restoration of lost functions in a person with Traumatic Brain Injury.

Intrathecal injection of Autologous stem cells derived from bone marrow in combination with neurorehabilitation have shown effective results and improvements in Brain injury patients. This is a completely safe procedure as the stem cells are extracted from the patient’s own body, thus eliminating the risk of rejection and other side-effects. As adult stem cells derived from bone marrow are used for treatment, there is no ethical concern regarding the use of therapy.

What are the expected outcomes after stem cell therapy for brain injury?

Stem cell therapy for Brain Injury in India is an effective and safe medical procedure. Clinical data and research analysis from top hospitals, such as NeuroGen, provides evidence for the potential of stem cell therapy for treatment of traumatic brain injury.

The overall improvement has been observed in almost 94% of the patients with head injury. Significant improvements were seen in:

  • Mental functions
  • Posture
  • Upper limb activity and lower limb activity
  • Trunk control
  • Sitting and standing balance
  • Coordination
  • Oromotor skills
  • Ambulation
  • Improvement in performing Activities of Daily Living (ADLs)

These improvements are supported by medical evaluations and tests also. The progress in patients was measured through various scales including Functional Independence Measure (FIM), Disability Rating Scale (DRS), SF-8 questionnaire and others. They also showed improved scores after stem cell therapy in brain injury patients.

Frequently asked Questions (FAQs) about Stem cell therapy for Brain Injury in India

Q. Can I completely recover from a TBI?

The extent of recovery from a Traumatic Brain Injury depends on the severity of damage to the brain. In addition to this, the parts of the brain that are injured are also known to play an important role in determining the prognosis of the patients.

Q. When are the benefits of stem cell therapy seen?

Maximum improvements have been observed around 3-6 months following stem cell treatment. In some patients, the progress is slow and full improvements may appear several months/years after the therapy. However, some immediate improvements can be seen in most patients before the discharge.

Q. Is it painful?

The process doesn’t cause severe pain or discomfort to the patient. Intrathecal transplantation of bone marrow mononuclear cells involves a process called bone marrow aspiration. In this, extraction of stem cells from bone marrow is done using a thin needle. This is performed under local anesthesia and patients won’t feel pain during the process. For children or people who can’t bear the process general anesthesia or sedatives may be given. Read more about the procedure here.

Vanshika Rawat

Written By Vanshika Rawat

Vanshika Rawat is an experienced content developer. She is very knowledgeable in the field of science and healthcare and has worked under brilliant scientists during her higher education. Vanshika obtained her degrees in Masters in Science and Bachelors in Science (Microbiology with Hons.) from renowned institutions - Panjab University and University of Delhi.

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