Molecular hydrogen-rhodiola as an adjuvant therapy for ischemic stroke in internal carotid artery occlusion: A case report

OBJECTIVES: Acute ischemic stroke caused by internal carotid artery (ICA) occlusion carries high risks of disability and death. While treatments such as thrombolysis, mechanical thrombectomy, and revascularization offer benefits, many patients experience limited recovery. Molecular hydrogen, with its antioxidant and anti-inflammatory properties, shows promise as a neuroprotective agent. This case report explores the adjunctive use of molecular hydrogen-rhodiola therapy in a patient with ICA occlusion, with a focus on immune modulation and clinical outcomes.

CASE PRESENTATION: A 68-year-old male with a history of paroxysmal atrial fibrillation presented with left-sided hemiplegia and was diagnosed with right ICA occlusion (NIH Stroke Scale: 12; modified Rankin Scale: 5). Endovascular thrombectomy was attempted but unsuccessful (modified Thrombolysis in Cerebral Infarction score = 0). The patient subsequently underwent superficial temporal artery to middle cerebral artery bypass surgery. Postoperatively, he was initiated on daily molecular hydrogen-rhodiola capsule therapy. Serial immunological assessments demonstrated a progressive increase in type 1 regulatory T (Tr1) cells and regulatory B cells, along with enhanced T-cell immunoglobulin and mucin-domain containing-3 (TIM-3) expression on cytotoxic T (Tc) cells. Clinically, the patient exhibited marked neurological recovery, with motor strength improving from Medical Research Council grade 1 to grade 5 in the affected limbs over six months. Notably, steroid therapy was discontinued without relapse, and no adverse events were observed.

CONCLUSION: This case highlights the potential of molecular hydrogen-rhodiola therapy as a safe and effective adjunctive treatment for ischemic stroke due to ICA occlusion. Notable improvements in immune modulation and motor function support its possible role in neurovascular recovery.