Stem Cells, Exosomes, and RPA: New Hope for Idiopathic Intracranial Hypertension (IIH)

Understanding IIH 

Idiopathic intracranial hypertension (IIH, also called pseudotumor cerebri) is a condition marked by chronically elevated pressure inside the skull with no tumor or hydrocephalus to explain it. The most common symptoms are severe daily headaches, ringing in the ears (pulse-synchronous tinnitus), transient vision disturbances or vision loss, and sometimes eye pain. On exams, doctors often find bilateral papilledema (swelling of the optic nerve head) and occasionally a sixth-nerve palsy. IIH most often affects overweight women of child-bearing age (about 10 times more than other groups). Untreated, prolonged high intracranial pressure can damage the optic nerves and lead to vision loss. Current treatments focus on weight management, medications (like acetazolamide), repeated spinal taps, or surgery (stents/shunts) to lower pressure. However, many patients seek new options.

Why consider regenerative therapy?

 Conventional approaches relieve pressure but do not directly repair tissue or address inflammation in the brain and optic nerves. In contrast, regenerative medicine – using stem cells, exosomes, or growth factor “cocktails” – aims to regulate the disease process, calm inflammation, protect nerves, and stimulate the body’s own repair pathways. Although IIH is still being researched, insights from related brain-injury studies suggest these therapies could help stabilize or improve symptoms by promoting healing. At the Stem Cell & PRP Institute of L.A., we offer advanced cell-based and exosome treatments, as well as a novel placental protein therapy (RPA), tailored for IIH patients.

What Are Stem Cells and How Might They Help IIH?

Mesenchymal stem cells (MSCs) are a leading cell type in regenerative medicine. These adult stem cells – obtained from a patient’s own bone marrow or fat (or sometimes from cord tissue) – can secrete a variety of neuroprotective and anti-inflammatory factors. Rather than permanently turning into new neurons, MSCs work by releasing growth factors, cytokines, and other bioactive molecules that can modulate the immune system, reduce swelling, and support nerve survival and blood vessel integrity. In brain injuries and stroke models, for example, MSCs have been shown to go to damaged areas and release factors that reduce secondary damage. 

Several animal studies highlight how stem cells can reduce brain edema and pressure. For instance, in a rodent brain hemorrhage model, MSCs injected during the acute phase decreased intracranial pressure and limited hemorrhage size – likely by strengthening the blood-brain barrier (upregulating tight junction proteins) and reducing bleeding. Similarly, in pediatric traumatic brain injury, one small clinical series showed that children treated with autologous bone marrow cells required less intensive therapy to control intracranial pressure than untreated controls. Although IIH is not the same as a stroke or hemorrhage, these findings suggest MSCs can create a more stable environment in the brain by easing inflammation and reducing fluid accumulation.

How might this help IIH?

 In IIH, chronic inflammation and altered cerebrospinal fluid (CSF) dynamics are thought to drive high pressure and optic nerve swelling. MSCs can release anti-inflammatory cytokines (like interleukin-10 and TGF-β) and growth factors (like VEGF, BDNF, FGF-2) that may promote repair of damaged nerve fibers and protect retinal ganglion cells. By improving microvascular circulation and lymphatic drainage in the brain, stem cells could facilitate CSF absorption and lower overall ICP (intracranial pressure). While no large trials in IIH exist yet, we extrapolate from neurotrauma studies that MSCs could potentially stabilize vision and symptoms.

In our clinic, treatments often involve an intravenous infusion or targeted injection (for example, into spinal fluid space) of the stem cells. 

Key benefits of MSCs (based on research in brain injury):

• Anti-inflammatory effects: MSCs secrete molecules that calm immune overactivation and reduce tissue swelling.
• Neuroprotection and neurotrophic support: They release factors that support neuron survival and regeneration (e.g. GDNF, BDNF).
• Reduced intracranial pressure: Animal studies show MSCs can strengthen vascular integrity, leading to lower ICP (intracranial pressure).
• Promotion of blood vessel repair: MSCs can aid angiogenesis and restore blood–brain barrier function.
• Stem cells have the ability to migrate toward sites of injury or inflammation, concentrating their beneficial effects where needed.

“In fact, in rodent studies of brain injury, MSC-derived exosomes (small particles from stem cells) reduced brain edema and intracranial pressure translational-medicine.biomedcentral.com. Likewise, in one clinical trial for pediatric brain injury, patients treated with bone marrow cells needed significantly less intervention to control ICP pmc.ncbi.nlm.nih.gov.”

By supporting the natural repair mechanisms, MSC therapy aims to stabilize the disease process in IIH. It’s not a guaranteed cure, but it offers a potential way to slow progression and protect vision. We discuss realistic expectations with each patient; since IIH varies greatly, some patients experience symptom relief and improved function, while others see only modest benefit. On the positive side, MSC treatments at our clinic are done in-office or outpatient, and patients typically resume normal activities soon after.

Exosome Therapy for IIH

Exosomes are tiny nanoscale “packages” (about 30–150 nm) released by cells, including mesenchymal stem cells. These vesicles carry proteins, messenger RNAs, microRNAs, and other molecules from their parent cell. Importantly, exosomes can cross the blood-brain barrier and deliver signals directly into brain tissue without needing whole cells. This means we can use exosomes to gain many benefits of stem cells while minimizing risks. 

How do exosomes help? They act like cellular messengers. MSC-derived exosomes contain anti-inflammatory microRNAs (like miR-21, miR-124) and proteins that help calm immune responses and prevent cell death in the brain. When administered (for IIH we typically give them intravenously), exosomes circulate and enter the central nervous system. There they can instruct microglia (brain immune cells) to adopt a healing phenotype (so-called M2 macrophage polarization) and promote repair pathways.

Research in brain injury models strongly supports exosome benefits. For example, one study found that MSC exosomes significantly reduced brain swelling and intracranial pressure in animal models after hemorrhagic shock. The treated animals also showed less inflammation and smaller injury lesions. In another experiment in rodents, early treatment with MSC exosomes after injury improved outcomes (better nerve survival and function). These experiments demonstrate that exosomes carry the potent regenerative cues of stem cells in a versatile form.

For IIH, exosome therapy is appealing because it addresses inflammation without needing direct cell injection into the nervous system. We know IIH involves inflammatory processes – indeed, a NASA-funded study found that patients with IIH had pro-inflammatory gene signatures in CSF exosomes. Using therapeutic exosomes may counteract that process. In practice, we administer exosomes intravenously (the dose and frequency tailored per patient). The treatment is well-tolerated, since exosomes lack nuclei or replicative capacity; they simply deliver their cargo and get cleared naturally.

Why MSC exosomes are promising: They cross the BBB easily, have low immunogenicity, and can be stored frozen for convenience. All of this suggests exosomes could be a safe and effective adjunct in IIH, helping to stabilize vision and reduce headache by addressing root inflammation and optic nerve edema.

Regenerative Protein Array (RPA) Therapy

Regenerative Protein Array (RPA) therapy is a novel approach we offer that goes beyond platelets. RPA is essentially a concentrated cocktail of growth factors, cytokines, and signaling proteins derived from placental tissues (the umbilical/placental “array” of molecules that supports fetal development). The placenta naturally contains hundreds of factors – including fetal growth factors, matrix proteins, and anti-inflammatory cytokines – all of which have potent healing properties. By isolating and formulating these into an injectable matrix, RPA provides a powerful regenerative stimulus.

Practically, RPA therapy is given intravenously. Because these are human-derived factors (from screened donor placenta/umbilical tissue), the treatment is non-immunogenic and has been used safely in wound healing and orthopedic cases. RPA contains many of the same signals stem cells secrete, but in a ready-made form. Clinics report that RPA has “magnitudes greater potency” than conventional platelet-rich plasma (PRP), largely due to its breadth of factors. Key components include vascular endothelial growth factor (VEGF), fibroblast growth factors (FGFs), insulin-like growth factor (IGF), transforming growth factor (TGF-β), and many placental-specific peptides. These drive angiogenesis, tissue regeneration, and immune modulation.

For IIH, RPA could theoretically aid healing by supplying an immediate surge of regenerative signals to the central nervous system. For example, the growth factors in RPA might promote repair of the optic nerve sheath or regulate cerebrospinal fluid dynamics. In our clinic, we combine RPA infusions with other therapies. In summary, RPA is an all-in-one “growth factor infusion.” By delivering a broad array of cytokines at once, RPA can accelerate the early regenerative process, complementing stem cell and exosome therapy. We ensure the product is rigorously screened and processed. As with other treatments, outcomes vary, but we have seen encouraging feedback in IIH patients who’ve combined RPA with cellular therapies.

How These Therapies Are Used at Our Clinic

At the Stem Cell & PRP Institute of L.A., we personalize treatment plans. A typical IIH protocol may involve:

• Pre-treatment assessment: Neurological and ophthalmologic exams, imaging, and lab tests to confirm IIH status.
• Stem cell harvest (if autologous): Liposuction or bone marrow aspirate to collect MSCs, followed by lab processing (concentration/culture).
• Treatment sessions: Administration of autologous or allogeneic MSCs (via IV or intrathecal injection) under sterile conditions. Following that, we infuse exosomes intravenously, and administer RPA infusions. These may be spaced over days or weeks based on patient status.
• Follow-up care: Monitoring visual function, headache diaries, and imaging. We often repeat treatments at 3–6 month intervals if needed, as IIH can be chronic.

All procedures are performed by Dr. Nourparvar. Our regenerative products come from FDA-compliant sources. By combining cutting-edge regenerative therapy with conventional treatment, many patients achieve better control of symptoms than with medication alone.

Evidence and Studies

Because IIH is relatively uncommon, direct clinical trials of stem cells or exosomes in IIH are limited. However, multiple preclinical and early clinical studies in related disorders support the potential benefits:

• Reducing Intracranial Pressure: In a rodent hemorrhage model, placenta-derived MSCs injected after injury significantly decreased ICP and hematoma volume. Similarly, in children with severe traumatic brain injury, intravenous autologous bone marrow cells were associated with a lower need for interventions to manage ICP compared to controls.
• Lowering Brain Edema: MSC exosomes have been shown to mitigate brain edema and reduce inflammation after injury. These effects contribute to lowering pressure on surrounding tissues.
• Neuroprotection: In stroke and trauma models, MSC-derived factors improved neuronal survival and functional recovery. For instance, MSC exosome treatment in animal model brain injury preserved neural tissue and cognitive function.
• Clinical Safety: Early human trials of MSC therapy in neurologic conditions (e.g. stroke, cerebral palsy) have generally reported good safety profiles, with few adverse events. In published cases, some IIH-like visual conditions (optic neuropathies) improved after stem cell therapy, though results are preliminary.

Taken together, these studies suggest that stem cell–based therapies can alter the disease environment in the brain in ways that could benefit IIH patients. The key mechanisms – anti-inflammation, angiogenesis, immunomodulation – are relevant to IIH pathology. We are carefully tracking our own patient outcomes and hope to contribute to the growing literature.

“Research indicates that MSCs and their exosomes exert powerful anti-inflammatory and protective effects in the brain. For example, one translational study noted MSC exosomes ‘significantly mitigate brain edema, reduce lesion size, [and] decrease intracranial pressure’ in a pig model translational-medicine.biomedcentral.com.”

At our clinic, we discuss each therapy’s evidence and limitations with patients. We emphasize that these are still emerging treatments – experimental in IIH – and individual responses vary. Nevertheless, many patients with refractory IIH have pursued these options when standard measures failed, and we have seen promising symptomatic improvement in some cases.

Frequently Asked Questions

Get Started – Contact Us

At Stem Cell & PRP Institute of L.A., we are dedicated to helping patients with IIH explore all avenues of treatment. If you or a loved one is struggling with IIH, consider speaking with our experts about stem cell, exosome, or RPA therapy. We offer a personalized consultation to review your case and discuss whether regenerative treatments may be appropriate.

Take the next step: Don’t wait for irreversible vision loss. Reach out today to learn if advanced regenerative therapy could help you manage idiopathic intracranial hypertension and improve your quality of life.

📞 Call us today at (310) 361-5480 to book your appointment or click here to schedule a consultation.