Motor Recovery and Structural Brain Improvement with Hydrogen-Oxygen Nanobubble (NB-HHO) Therapy in Acute Thrombotic Stroke: A Case Report

Abstract Background Ischemic stroke is a leading cause of long-term disability and standard therapies often fail to achieve complete recovery, particularly in patients with vascular comorbidities. Hydrogen-Oxygen Nanobubble (NB-HHO) therapy has emerged as a novel adjunct with antioxidant, anti-inflammatory, vascular protective, and neuroplasticity-enhancing properties. Case Presentation : A 48-year-old woman with hypertension, dyslipidemia and type 2 diabetes presented with a first-ever acute thrombotic stroke and complete left hemiplegia (NIHSS 11, MMSE 28). She underwent 50 intravenous NB-HHO infusions over three months, combined with physiotherapy. Early cranial nerve recovery was observed by session 4–6, followed by sequential motor milestones culminating in unassisted stepping by session 43. Quantitative MRI showed significant corticospinal tract expansion, new fiber tract formation and improved global efficiency. NIHSS declined from 11 to 6, while MMSE remained stable. Laboratory markers also improved. No major adverse events occurred. Discussion Clinical, imaging, and metabolic improvements correlated closely, supporting NB-HHO’s potential mechanisms: ROS scavenging, vascular repair, metabolic regulation, and neuroplasticity. The temporal relationship between therapy sessions and milestones suggests a synergistic effect with physiotherapy. Conclusion NB-HHO therapy was safe, well tolerated, and associated with accelerated motor and cranial nerve recovery in acute thrombotic stroke. Larger randomized trials are warranted to validate efficacy and establish standardized protocols.