Treatment of cerebral infarction | Overview including symptoms and causes

Cerebral infarction is a disease that occurs when blood vessels in the brain become blocked, thus obstructing blood flow and causing damage to brain cells. Its onset is sudden, and as the risk of sequelae increases if appropriate measures are not taken, prompt action is considered very important.
Conventional treatment strategies involve thrombolytic agents and surgical procedures; however, in recent years, regenerative medicine, including stem cell therapy, has attracted research interest and attention as a new option that can support brain tissue recovery.

In this article, we outline the symptoms, causes, and mechanism underlying the onset of cerebral infarction, while describing how stem cell therapy, which is an advanced approach, can contribute to the field along with conventional treatments. We hope that this information will help you gain insights on the precautionary measures that can be undertaken to prevent sudden onset, as well as the measures to manage emergencies.

What is cerebral infarction?

Cerebral infarction is a disease that occurs when a thrombus or embolus blocks an artery in the brain, and the resulting loss of oxygen and nutrient supply in downstream brain tissue causes dysfunction. It is a form of stroke and is one of the three major causes of death in Japan. This disease, which has become a major global health issue, is common in older adults but may also occur in young adults as a result of lifestyle habits and/or genetic factors.
Cerebral infarction is mainly classified into the following types:

• Atherothrombotic brain infarction: When a large artery in the brain is narrowed by atherosclerosis, a thrombus is formed, thus clogging the artery. This disease type is closely related to conditions such as hypertension, dyslipidemia, and diabetes mellitus.
• Lacunar infarction: A small penetrating artery in the deep area of the brain is occluded, forming a small infarct (lacune). Hypertension is the main cause, and the disease could occur multiple times.
• Cardiogenic brain embolism: A thrombus generated by a heart disease, such as atrial fibrillation, travels to the brain and blocks a large blood vessel. Patients with this type of cerebral infarction are prone to sudden and severe symptoms.

Since early detection and treatment affect the prognosis in all types of cerebral infarction, it is important to deepen our understanding of cerebral infarction. *1

*1 Reference: Kindai University Hospital

Symptoms of cerebral infarction

Symptoms of cerebral infarction vary depending on the site of onset and extent of infarction. Typical symptoms include:

• Hemiplegia: When the right brain is damaged, paralysis often occurs in the left side of the body, and when the left brain is damaged, paralysis often occurs in the right side of the body. Patients experience difficulty in moving hands and feet and decreased tactile sensation.
• Language disorder: When the left hemisphere, which contains the language center, is damaged, patients find it difficult to speak (aphasia) or understand words.
• Facial paralysis or drooping of the corners of the mouth: The balance between the left and right sides of the face may be disrupted, which can result in drooping of the corners of the mouth and visual bias.
• Visual field defect: Some patients may also experience visual deficits, such as hemianopsia or diplopia, wherein the simultaneous perception of two images of a single object occurs.
• Disturbance of consciousness or coma: In severe cases, patients may fall into a coma due to a depressed level of consciousness.
• Cerebellar symptoms: If blood flow in the cerebellum is insufficient, lightheadedness, ataxia, etc., may occur, making it difficult to balance or make a smooth movement.

Given that sudden onset of symptoms is a characteristic of cerebral infarction, an early visit is recommended if the individual displays the FAST (Face: facial drooping, Arm: arm paralysis, Speech: speech difficulties, Time: time) signs. *2
*2 Reference:  Yokohamashintoshi Neurosurgical Hospital

Causes of cerebral infarction

The main cause of cerebral infarction is blockage of a blood vessel in the brain by a thrombus or embolus. The following factors are considered to contribute to cerebral infarction:

• Atherosclerosis: A plaque (buildup of fats) is formed in the vascular wall due to conditions such as hypertension, dyslipidemia, and diabetes mellitus, causing narrowing and hardening of the blood vessel. Eventually, the vessel becomes more prone to clot formation.
• Heart disease: A blood clot is formed in the heart due to arrhythmias, such as atrial fibrillation; this clot travels to the brain and blocks a blood vessel.
• Hypertension: Many years of hypertension can damage small arteries, causing lacunar infarcts.
• Diabetes mellitus: Hyperglycemia damages the vascular endothelium, leading to the progression of arteriosclerosis.
• Smoking, obesity, stress: These lifestyle habits promote arteriosclerosis and thrombus formation and increase the risk of cerebral infarction.

Regular medical checkups and lifestyle improvement are necessary for preventing cerebral infarction. *3
*3 Reference: Otsuka Pharmaceutical Co., Ltd.

Stem cell therapy as a promising treatment for cerebral infarction

What is stem cell therapy?

Stem cell therapy is a regenerative medicinal approach that aims to repair and regenerate damaged tissue using stem cells, which have the ability to both self-renew and differentiate into multiple cell types. In cerebral infarction, the theoretical aim is to introduce stem cells into necrotic brain tissue to support cell generation and functional improvement of surrounding tissues. Stem cells collected from the patient’s own bone marrow or fat (autologous cells) are often used and expected to reduce the risk of rejection and adverse reactions in the body.

Advantages of stem cell therapy

Stem cell therapy has attracted attention as a treatment for cerebral infarction for the following reasons:

• Attempt to regenerate neurons: Stem cell therapy aims to achieve functional recovery by generating new neurons or inducing angiogenesis to replace dead brain cells.
• Improvement in the chronic phase of cerebral infarction: Achieving dramatic recovery after the acute phase is considered to be difficult; however, the multifaceted effects of stem cells are believed to potentially improve symptoms, even in the chronic phase.
• Reduced risk of side effects: If autologous cells are used, severe rejection will not occur as these cells are highly biocompatible.

Reasons why stem cell therapy is effective

Stem cells not only differentiate into specific cells but also suppress inflammation by secreting cytokines, thereby supporting the regeneration of blood vessels and nerves. The sequelae of cerebral infarction result from the death of neurons and impaired blood flow, which are intricately intertwined; stem cells, with their multifaceted actions, can potentially repair this environment. However, not all patients experience dramatic effects. Many factors influence these effects; these factors include individual differences, extent of the lesion, and time since onset.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

The Regenerative Medicine Division of Korokai Medical Corporation provides stem cell therapy for cerebral infarction by implementing the following process:

1. Initial consultation and tests: We will judge the necessity for stem cell therapy through a comprehensive evaluation of the patient’s medical history, current neurological symptoms, and brain imaging test results.
2. Stem cell collection and culture: Stem cells will be extracted from the patient’s fat and cultured. They will be managed and monitored for quality and safety throughout the process.
3. Preparation of the treatment plan: The frequency and method of administration of stem cells will be determined based on the degree of paralysis and the extent of damaged area in the brain. The route of administration, such as intravenous infusion or local injection, will be decided based on the patient’s condition.
4. Administration and follow-up: After the administration of stem cells, instructions to introduce rehabilitation, etc., will be provided, and changes in symptoms and adverse reactions will be monitored. Re-administration may be considered if necessary.

Although stem cell therapy is less invasive than surgery in most cases, continuous monitoring is important because the effects vary between patients.

Possibility of treating cerebral infarction using stem cells

Cerebral infarction is a severe disease in which the nerve function is rapidly impaired due to the interruption of blood flow within the brain, requiring prompt treatment. Stem cell therapy, which has been used in regenerative medicine in recent years, has the potential to support the regeneration of lost tissue and angiogenesis in a multifaceted manner. It is also expected to improve symptoms, even in the chronic phase of cerebral infarction.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and offers regenerative medicine according to each individual’s concerns based on novel comprehensive treatment strategies. To optimize the results, oral therapies such as bioidentical hormone replacement therapy or peptide therapy may be combined with stem cell therapy, as per the patient’s needs.

*4 Source: Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo
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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue and then injecting them locally to the affected area or administering them via intravenous infusion.
[2] Risk of side effects
At the time of fat collection: Adverse reactions, such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site, may be observed.
At the time of stem cell administration: Adverse reactions, such as pain at the injection site, allergic reaction, and pulmonary embolism, may be observed.
[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
Precious 18 5F, 4-14-6 Minami-azabu, Minato-ku, Tokyo
TEL:03-6277-4650
[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance. It will cost about 1.65 million yen including tax (which may vary depending on diagnosis).
Please contact us for further details.
[5] Route of acquisition
Stem cells are cultured at the affiliated CPC.
[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.
[7] Safety information from other countries
There are no reports on safety in other countries.
*Significant risks may not have been identified.
[8] The fact that it has not been approved
Drugs used in this treatment are yet to receive approval in accordance with the Pharmaceutical and Medical Device Act.
[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.
[10] Notification of regenerative medicine provision plans
To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230187
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3240017
Ministry of Health, Labour and Welfare, Class 2 Regenerative Medicine Provision Plan No. PB3230218