A traumatic brain injury (TBI) is any type of injury to the brain that has lasting side effects. A TBI can happen at birth if there is an injury to the baby during labor or delivery; in fact, some cases of Cerebral Palsy are considered TBIs. A concussion is also a form of a TBI. Larger TBIs are often seen in car accident victims and injured combat veterans who experience blunt force or blast trauma to the head. Internal injuries such as hypoxic events (near-drownings, choking, etc) and strokes are classified as non-traumatic brain injuries, but the long term effects are often the same.
An injury to the brain creates immediate swelling, or inflammation. This is a natural response to an injury as the body works to protect and respond to the injured area. Once the bleeding is controlled and scar tissue is formed, the inflammation is supposed to recede. Unfortunately, it is common for inflammation within the brain to become chronic. When the brain swells, pressure builds on top of blood vessels and it becomes difficult for the blood to flow through the injured areas. This results in decreased oxygen and nutrients to the affected area. Depending on where this occurs within the brain, the patient may experience a partial or complete loss of mobility or cognition. TBI patients often struggle with uncontrollable emotional responses, memory loss, and confusion. Severe TBIs can result in complete loss of brain function or death.
Hyperbaric Oxygen Therapy has been utilized for both emergency treatment immediately following a traumatic brain injury and for treatment for the long-term symptoms of an old injury. According to research, in order for a patient to utilize HBOT during an acute TBI, they need to be treated within 48 hours of the injury. The pressurized oxygen can reduce any inflammation that has already begun at the source of the injury. It may also prevent the brain from having any long-term damage due to the lack of further inflammation in the tissues.
If a patient is unable to treat their acute TBI with hyperbaric therapy, they may still see benefits from the modality, even decades after the event. Increased oxygen to the brain may reduce residual neuroinflammation and allow for more blood flow to the damaged tissues. This can lead to partial or full repair of the brain. Research from Dr. Paul Harch and others have shown that there is no time limitation on repairing damaged brain tissue. Patients have reported regaining full mobility and cognition after a series of hyperbaric treatments.
Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18–65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied. The measures included symptom lists, physical exam, neuropsychological and psychological testing on 29 subjects (1 dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due to the HBOT: reversible middle ear barotrauma (n = 6), transient deterioration in symptoms (n = 7), reversible bronchospasm (n = 1), and increased anxiety (n = 2; not related to confinement); unrelated to HBOT: ureterolithiasis (n = 1), chest pain (n = 2). Significant improvement (29 subjects) was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD, depression (including reduction in suicidal ideation), and reduced psychoactive medication usage. At 6-month follow-up subjects reported further symptomatic improvement. Compared to Controls the subjects' SPECT was significantly abnormal, significantly improved after 1 and 40 treatments, and became statistically indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be safe and significantly effective for veterans with mild to moderate TBI PPCS with PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, and SPECT imaging. Veterans also experienced a significant reduction in suicidal ideation and reduction in psychoactive medication use.
A 2-year-old girl experienced cardiac arrest after cold water drowning. Magnetic resonance imaging (MRI) showed deep gray matter injury on day 4 and cerebral atrophy with gray and white matter loss on day 32. Patient had no speech, gait, or responsiveness to commands on day 48 at hospital discharge. She received normobaric 100% oxygen treatment (2 L/minute for 45 minutes by nasal cannula, twice/day) since day 56 and then hyperbaric oxygen treatment (HBOT) at 1.3 atmosphere absolute (131.7 kPa) air/45 minutes, 5 days/week for 40 sessions since day 79; visually apparent and/or physical examination-documented neurological improvement occurred upon initiating each therapy. After HBOT, the patient had normal speech and cognition, assisted gait, residual fine motor and temperament deficits. MRI at 5 months after injury and 27 days after HBOT showed near-normalization of ventricles and reversal of atrophy. Subacute normobaric oxygen and HBOT were able to restore drowning-induced cortical gray matter and white matter loss, as documented by sequential MRI, and simultaneous neurological function, as documented by video and physical examinations.
Hyperbarics offers hope and healing!
Dr. Harch treats traumatic, hypoxic and anoxic brain injuries
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