Hi Cheryl,

I advice you this recent review on cell therapies for stroke and brain injury in which the authors emphasizing on the role of microglia in the inflammatory response subsequent to an brain injury (treatment with bone marrow mononuclear cells).

Check it out! "Concise Review: Cell Therapies for Stroke and Traumatic Brain Injury: Targeting Microglia" (Savitz & Cox, 2016).

For more information about this treatment : "Autologous bone marrow mononuclear cells reduce therapeutic intensity for severe traumatic brain injury in children." (Liao et al., 2015).

Regards.

Thank you so much Geoffrey, I will go and have a look at the research, it sounds very interesting.

Dear Cheryl,

I do agree with Geoffrey with regard to the effect of stem cells; there are recent reports about it. However, the problem, in TBI, for instance, or Diffuse Axonal Injury occurring as a consequence of it or due to Cardiac Arrest is the time needed for harvesting autologous stem cells, expanding them until arising a significant number and injecting them back to the patient. During this time the cascade of inflammatory signals turned on by diffuse axonal injury is progressively increasing, making the brain damage stronger. In my opinion, and in my experience, the best urgent solution for blocking pro-inflammatory cytokines and avoiding the dead cascade is to administer melatonin, at doses no lower than 10 mg, it can be increased through 200-400 mg though. 

Best regards

Jesús Devesa, MD, PhD

Professor of Physiology

Specialist in Endocrinology and Magister in Advanced Regenerative Therapies

Thank you so much Jesus. If a paramedic attended a brain injury and immediately gave them melatonin, would this dramatically decrease damage. I have been asked about this by paramedics and it is a very interesting question.

Yes, melatonin counteracts pro-inflammatory cytokines immediately released after a brain injury; they are responsible for the cascade of events leading to diffuse axonal injury and further brain damage. The only problem is how to administer melatonin. Usually it is given orally, but it can be injected intravenously, since a TBI patient lacks a normal deglutition. Doses iv could be about 20 mg. 

Thank you Jesus, that is good news.

Currently it appears that Hypothermia, limited use of oxygen saturation, as well as certain pharmacological drugs are the most important forms of official prevention, however in rehabilitation it appears to be limited to physical and neuropsychological therapies, until it is deemed that these therapies have worked to the optimal level. If function is not recovered, the recovery of function is then left to the auspices of time. Currently the only treatment I am aware of is that Dr Devesa and this appears to be the only one that is successful in patients who have remained comatose, vegetative or have not recovered functionality in severe cases.