Seema Tewari¹*, Vinod Kumar² and Lori Tewari³

¹Assistant Director, Department of Physiology, Advance Neuro and General Hospital, India
²Consultant Neurosurgeon, Advance Neuro and General Hospital, India
³EMO, Advance Neuro and General Hospital, India

*Corresponding Author: Seema Tewari, Assistant Director, Department of Physiology, Advance Neuro and General Hospital, India.

Received: August 20, 2025; Published: September 09, 2025

Abstract

Background: Tissue Plasminogen Activator (tPA) showed a level 1 benefit in acute stroke (within 4.5 hours). But for more than 4.5 hours cases (if they fail to qualify for clot retrievers) Intracarotid/Intraarterial sodium nitroprusside (ICSNP/IASNP) has been studied by the author previously from 5th day to 21st day has shown promising results. Actually, most of the cases in developing and even in developed countries are there which arrives to clinicians after this time window of 4.5 hours. But after giving IASNP in those cases and activating the 10,000-fold effect those cases show decrease in power after 24 hours. Platelet rich plasma (PRP) is thereby utilized to provide growth factors at the cyton level to maintain and restore the raw materials for the synaptic flow of 10,000-fold effect along with ICSNP via the same port.

Aims/Study Design: Post 24 hours IASNP activation (10,000-fold effect) causes decrease in power of the recovered area which is restored by the PRP at the cyton level are the basis of the authors’ hypothesis to treat sub-acute stroke cases from 5th day to 21st day. Pilot study on 7 cases prospective study.

Materials and Methods: The population included 7 stroke patients. The mean time for superfusion was 8 days post-stroke. Pre- and post-IASNP with Double dose PRP (IASNP with DD-PRP) status was monitored by NIHSS, MRI-DWI, ALTENS.

Results: After 2 hours of IASNP with DD-PRP, the mean change in the NIHSS score was a decrease of 9.5 points; after 2 h, there was a decrease of 2 points; after 24 h, there was an decrease of 2.5 points, at 7 days there was an 3-point decrease, at 3 weeks there was a decrease of 0 points; at 3 month there was a 0-points decrease, well documented by NIHSS, MRI and ALTENS study.

Conclusions: IASNP causes improvement in neurological deficit in these 7 cases but after giving PRP via same port we didn’t find any decrease in benefitted neurological deficit.

Keywords: Brain Infarcts; Intracarotid Sodium Nitroprusside; Perforators’ Vasodilations; Retrograde Neurotransmission; The 10,000-Fold Effect, PRP. NIHSS, MRI-DWI, ALTENS

References

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Citation

Citation: Seema Tewari., et al. “Intracarotid Sodium Nitroprusside with Double Dose Platelet Rich Plasma In Sub Acute Ischemic Stroke Cases (From 5th To 21st Post Stroke Day) To Prevent Post 24 Hours Power Decrease – Pilot Study In 7 Cases".Acta Scientific Neurology 8.10 (2025): 10-15.

Copyright

Copyright: © 2025 Seema Tewari., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.