This study aims to determine the efficacy of intravenous transplantation of autologous bone marrow-derived mesenchymal stem cells in patients with acute middle cerebral artery infarct.

Inclusion Criteria:

• Experiences stroke onset within 2 weeks to 2 months
• NIHSS score of >10-35
• Never received or failed thrombolysis
• Evidence of unilateral middle cerebral artery infarct on brain MRI

Exclusion Criteria:

• Medically unfit (eg. those are unstable haemodynamically despite treatment, with worsening conscious level and with other serious medical co-morbidity)
• Evidence of any tumor or other space-occupying lesion on brain MRI
• Evidence of hemorrhagic stroke on brain CT or MRI
• Experiences transient ischemic attack or lacunar infarct
• Has any acute or chronic infections such as Hepatitis B, Hepatitis C and HIV
• Is diagnosed with concurrent malignancy or primary hematological disorders
• Renal impairment indicated with serum creatinine greater than 200 umol/l or creatinine clearance less than 30 ml/min
• Liver impairment indicated with serum aspartate transaminase and serum alanine transaminase greater than 4 times upper limit of the normal range
• Any contraindication to stem cell transplantation or bone marrow biopsy
• Any co-morbidity which will compromise the ability to obtain adequate stem cells (eg. chronic debilitating diseases, frail patients and patients with known osteoporosis)
• Any contraindication to brain MRI (eg. metal implants, pacemaker, joint implants and ocular implants)