Doctors and researchers alike are the first to admit that the brain is the last bastion of uncharted body territory. However, by degrees, more and more is being learned and procedures developed to ‘chart' the brain, learn which areas control which physical activity, and to heal areas which have become damaged.
It is well-known that stroke is notoriously difficult to treat. Haemorrhagic strokes account for around thirty per cent of the 150,000 strokes in the UK each year. Stroke is Britain's third biggest killer, after heart disease and cancer, and causes more disability than any other disease. It costs the economy about £7 billion a year, including NHS bills and lost productivity.
Up until now, the only option has been conventional surgery, which has a variable success rate. Half of such surgery patients currently die within a month and just one in twenty patients will recover, to varying degrees. Moreover, depending on the precise site of the injury or embolism, the resulting physical effects can be different from patient to patient.
But now, an innovative technique has emerged. A brand-new, pioneering treatment called Cell Beads has been developed. It involves cutting away part of the skull to tie off leaking blood vessels and remove blood from the brain. Then, surgeons insert a 2cm by 2cm bag filled with capsules stuffed with around a million stem cells. These stem cells, taken from bone marrow, are genetically engineered to make a drug known as CM1 that protects brain cells from dying. This lets the cells rejuvenate and repair the damage done by the stroke. Once implanted into the brain, it is hoped they will have an anti-inflammatory effect, thereby preventing further brain cells from dying.
Walter Bast was only 49 when he lost the use of his right arm through stroke. Because of his relative youth, he was an ideal patient for this revolutionary trial involving - of all things - a teabag! Mr Bast, a mechanic from Bremen in Germany, agreed to be the first to test the operation after suffering two strokes in quick succession.
First, genetically-modified stem cells were fitted into this new kind of miracle ‘tea bag'. Then, brain surgeons placed the customised ‘teabag' filled with stem cells directly into Walter's brain.
After around two weeks, doctors at the International Neuroscience-Institute in Hanover, Germany, removed the 'teabag' from Walter's brain. And the result? Remarkably, he has regained his speech and the use of his right arm again. Speaking a week after the operation, the first of its kind in the world, Mr Bast said: "I feel a lucky guy." His surgeon, Professor Thomas Brinker, said: "We see a recovery as good as this in only the minority of patients, so it is an encouraging start. It is important that we found no side-effects." But stem cell scientists warned that many safety and ethical hurdles would have to be crossed before the treatment was accepted for widespread use.
The Cell Beads treatment was developed by a British medical technology company called Biocompatibles International, which is based in Farnham, Surrey. The whole process relies on ‘hiding' the stem cells from the immune system to ensure they are not rejected by the body. What the Biocompatibles' scientists have developed is a collection of beads which do just that. Enclosing everything in the 2cm square 'teabag' ensures the surgeon can easily remove it at the end of the treatment period.
Dr Peter Stratford, of Biocompatibles, said a one-size-fits-all treatment could be stored in hospital freezers ready for use when required. If effective, it could have a huge impact on patients' quality of life and save the NHS billions.
An exciting co-operative partnership could then be started. Once this innovative surgery and follow-up physiotherapy have produced the desired physical results, then appropriate mental health therapists can continue the good work by extending the improvements by one-to-one therapy sessions.
For many stroke victims, there may well have been a negative build-up of thoughts on how their past life is now over. The combination of this pioneering surgery and therapy can help patients rediscover how to communicate with others and address a range of issues which their condition has impacted upon them. Above all, therapy will help patients to accept their new level of functionality, manage their anger, become more confident of just what they can achieve, and feel more in control of themselves and their life.
There is no doubt that stroke is a major trauma, but with the combined efforts of amazing surgery techniques plus ongoing therapy, life can be transformed.
