Hyperbaric Oxygen Therapy for Brain Injuries

Physicians, institutions and the military are all utilizing or researching hyperbaric oxygen therapy for traumatic brain injuries. But the chief hyperbaric medical association has yet to approve it for this condition, creating an obstacle for proponents and patients.

Injury

• After a severe head injury, traumatic brain damage may occur as the brain swells, wedging sensitive tissues against the skull. In the book "Hyperbaric Oxygen Therapy," Richard A. Neubauer and Morton Walker write that hyperbaric oxygen therapy (HBOT) works to treat brain injury by "constricting the brain's blood vessels, yet delivering more oxygen." This type of therapy works by increasing oxygen content in plasma, a part of the blood that normally does not carry oxygen throughout the body.

Military Research

• The San Antonio Military Medical Center Hyperbaric Center and the Air Force School of Aerospace Medicine are researching hyperbaric oxygen therapy for brain injuries among wounded soldiers. "We hope that hyperbaric oxygen therapy will stimulate the area around injured brain tissue to improve the patients' cognitive functions," says Dr. E. George Wolf, a physician with the SAMMC Hyperbaric Center. The team also plans to closely watch for signals indicating whether or not HBOT may minimize symptoms of post-traumatic stress disorder.

Private Research

• Dr. Paul Harch, head of Harch Hyperbarics Physicians Center in New Orleans, is also involved in private research with other physicians to treat veterans of the Iraqi and Afghanistan wars. According to Dr. Harch, when cells in the brain die, either from trauma or lack of oxygen, blood plasma leaks out into surrounding brain tissue, causing swelling and reducing blood flow. The extra oxygen from HBOT helps to heal injured capillaries and reduce swelling. This restores blood flow and much-needed oxygen to the damaged tissue, reviving the dormant cells and spurring a healthful state.

Barrier

• Traumatic brain injury is not one of the 13 "indications" approved by the Undersea and Hyperbaric Medical Society (UHMS) as conditions clearly suited for treatment by HBOT. In 1976, UHMS convened a committee to determine the medical conditions most likely to receive benefit from this therapy. At the time the committee did not recommend oxygen treatment for brain trauma. While many physicians, institutions and patients now utilize HBOT for treatment of brain injury, many insurance plans and the federal government may not cover the financial cost.

Building Support

• Hyperbaric oxygen therapy also works to repair what is known as the blood-brain barrier, a defensive layer of cells that pushes away toxins trying to sneak into the brain. This natural protection is often damaged when severe head trauma occurs. According to Dr. Kenneth P. Stoller, Medical Director of the Hyperbaric Medical Center of New Mexico, hyperbaric oxygenation has been shown in a controlled trial to reduce the mortality of head injury by 50 percent.