The authors report the case of a 40-year-old man who suffered paraplegia from 2013, due to shot by firearm. In april 2017 he underwent cell therapy consisting of administration of autologous bone marrow stromal cells (BMSCs) into injured spinal cord and subarachnoid space by lumbar puncture. Throughout one year of follow-up, the patient experienced clear improvement in sensitivity, motor, and sphincter functions. After BMSCs administration, studies with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) suggested an enhancement in glucose uptake at level of injured spinal cord, at least in the course or the first 6 months after the start of cell therapy. This case supports previous observations about the improvements obtained by cell therapy with autologous BMSCs in chronic paraplegic patients, and suggests that a possible increase in tissue metabolism, mediated by the presence of BMSCs into injured spinal cord, can be one of the causes of early clinical improvements.
Background: The possibility of an increase in brain glucose metabolism after intrathecal administrations of autologous mesenchymal stromal cells (MSCs) has been recently reported, suggesting a role in the treatment of neurological disorders. We describe here the utility of this type of cell therapy in chronic neurological sequelae due to cerebral hemorrhage. Methods: A 49-year-old female suffered from 2009 severe neurological sequelae after spontaneous intracerebral hemorrhage open to ventricle in the left frontoparietal region. Eight years later, she received 3 intrathecal administrations of 100 million autologous MSCs each three months, until a total dose of 300 million. Results: From the first administration of MSCs, the patient reported a clear and progressive improvement that is maintained one year after finishing the cell therapy. The neurological improvement was associated to a progressive increase in global brain glucose metabolism measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET). Conclusions: Late intrathecal administration of cell therapy with autologous MSCs may be a useful strategy to achieve improvement of chronic neurological sequelae due to hemorrhagic stroke.
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