Intravenous Stem cell Therapy for High Grade Aneurysmal Subarachnoid Haemorrhage: Case Report and Literature Review

Abstract Background and Importance: Aneurysmal subarachnoid haemorrhage is associated with high mortality (30-40%) and morbidity with long-term physical, neurologic and/or psychologic impairments; most of which are patients presenting with high initial Hunt & Hess grade. In view of the great need for efficacious therapies for high grade SAH, recent animal studies have demonstrated improved outcomes with administration of mesenchymal stem cells (MSCs) as a potential neuroregenerative strategy. We present the first case of human intravenous administration of MSCs after aneurysmal subarachnoid haemorrhage. Clinical presentation An 80-year-old male presented with sudden severe headache with nausea and vomiting and CT-scan demonstrated subarachnoid haemorrhage with hydrocephalus from a ruptured basilar tip aneurysm. Initial exam of the patient was H&H and WFNS grade 5. The patient was treated with EVD placement and coiling of the aneurysm. The patient received an infusion of intravenous bone marrow derived allogeneic mesenchymal stem cells (MSCs) on day 3 post-bleeding. The patient made a better recovery then anticipated with an mRS of 3 at 6 months. Conclusion Several studies using models of ischemic brain injury have found that mesenchymal stem cells administration may improve functional neurological recovery and decreases brain lesion volume. While there have been limited human studies in stroke patients, the role of stem cell therapy for aneurysmal SAH remains unclear. This is the first case of MSC use in human for the treatment of aSAH. In conjunction with the promising results in animal studies, this encouraging preliminary case report supports the need for additional clinical trials.