title: Stem Cells as a Potential Adjunctive Therapy in Aneurysmal Subarachnoid Hemorrhage.
abstract: BACKGROUND
  Despite advances in the management of subarachnoid hemorrhage, a considerable proportion of patients are still left with severe and disabling long-term consequences. Unfortunately, there are limited therapeutic options to counteract the sequelae following the initial insult. The role of stem cells has been studied in the treatment of various diseases. The goal of this study was to provide a literature review regarding the potential advantages of stem-cell therapy to counteract or minimize the sequelae of aneurysmal subarachnoid hemorrhage.
  
  
  METHODS
  PubMed, Google Scholar, and ClinicalTrials.gov searches were conducted to incorporate pertinent studies that discussed stem cell use in the management of subarachnoid hemorrhage. Included articles were subjected to data extraction for the synthesis of the efficacy of stem-cell therapy.
  
  
  RESULTS
  Four preclinical studies with 181 animal model subjects (44 mice, 137 rats) were incorporated in our review. Endovascular punctures (65%) and blood injections in subarachnoid spaces (17%) were used to induce hemorrhage models. Stem cells were administered intravenously (3.0 × 10(6) cells) or intranasally (1.5 × 10(6) cells). According to literature, mesenchymal cell therapy significantly (p<0.05) induces stem-cell migration to lesion sites, decreases associated neural apoptosis and inflammation, improves ultrastructural integrity of cerebral tissue, and aids in improving sensorimotor function post subarachnoid hemorrhage.
  
  
  CONCLUSIONS
  Stem cells, particularly mesenchymal stem cells, have shown promising cellular, morphological, and functional benefits in animal models suffering from induced subarachnoid hemorrhages. However, further studies are warranted to elucidate the full effects of stem-cell therapy for aneurysmal subarachnoid hemorrhage.
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Hesham T
authors.initials: HT
authors.lastname: Ghonim
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sumedh S
authors.initials: SS
authors.lastname: Shah
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Thompson
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Ambekar
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Peterson
authors.affiliation: Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Mohamed Samy
authors.initials: MS
authors.lastname: Elhammady
keywords: Intracranial aneurysms; mesenchymal stem cells; stem cells; subarachnoid hemorrhage