Regenerative strategies in the treatment of acute stroke may have great potential. Hematopoietic growth factors mobilize hematopoietic stem cells and may convey neuroprotective effects.
Three cohorts of patients 8, 6, and 6 patients per cohort were treated subcutaneously with 2. Standard treatment included IV thrombolysis. Voxel-guided morphometry VGM enabled an assessment of changes in the patients' structural parenchyma. G-CSF treatment was discontinued in 4 patients because of unrelated adverse events.
Neuroradiological and neuropsychological follow-up studies did not disclose any specific G-CSF toxicity. VGM findings indicated substantial atrophy of related hemispheres, a substantial increase in the CSF space, and a localized increase in parenchyma within the ischemic area in 2 patients.
We demonstrate a good safety profile for daily administration of G-CSF when begun within 12 hours after onset of ischemic stroke and, in part in combination with routine IV thrombolysis. Additional analyses using VGM and a battery of neuropsychological tests indicated a positive functional and potentially structural effect of G-CSF treatment in some of our patients.
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