Stroke is caused by a sudden loss of blood and oxygen to a specific area of the brain, which kills off a central core of brain cells. With the death of these cells and the swelling this causes, blood and oxygen are further isolated from the surrounding cells, which also then swell... and the cycle tends to repeat itself. These surrounding cells - rather than the central core itself - can cause much of the stroke patient's disability. If these marginal (viable, but not functioning) cells can be revived with sufficient oxygen, substantial and sometimes dramatic recovery may result.
HBOT can aid in the stroke victim's recovery in a variety of ways, including:
Relief of hypoxia (lack of sufficient oxygen)
Cerebral edema and spasticity
Extra vascular diffusion of oxygen
Improvement of micro-circulation
In a review of many studies, more than 1,000 patients who sustained cerebrovascular disease and were treated with HBOT showed improvement in quality of life.
Coma is defined as a state of profound unconsciousness caused by disease, injuries, or poison. Coma may last up to four years causing severe incapacitation, financial burden, and distress to the family. In most cases, the patient has been in a coma over three months and has fairly regained his or her physical abilities. The Ocean Hyperbaric Center has treated a number of patients with long standing coma, even up to 12 years, who have shown varying degrees of improvement including a return into society. This is the unusual case, but frequently a lessening of care, removal of PEG tube, and tracheotomy may be accomplished using intensive HBO therapy. This is validated again with sequential SPECT imaging before, during, and after coma. Some of these patients may require up to 300-500 HBO therapy sessions. All modalities of physical therapy, occupational therapy, speech therapy, and ancillary types of therapy are used. Dr. Neubauer has reported an overall 50% success rate in the therapy of long-term coma.
Multiple Sclerosis (MS) patients with Kurtze category less than five respond very well to hyperbaric oxygenation. Currently there are 12,000 MS patients being treated at 110 centers in the United Kingdom. The results are the same as was published by Dr. Neubauer in 1978 and 1980 in the Florida Medical Journal:
1) It is not a cure.
2) It is dose sensitive.
3) It requires long term follow up therapy.
4) It alters the natural history of the disease in a favorable fashion.
MS is a demyelinating disease of the central nervous system (CNS). It is characterized by exacerbations, remissions, and stability. It is aggravated by any type of stress whether it be an automobile accident, an infection or other types of trauma, even emotional. When the disease is erratic, remissions may last for years. This is a debilitating disease and during exacerbation or in rapidly deteriorating patients, they may be wheelchair bound for the rest of their lives only several years after the diagnosis. There have been hundreds of treatments for MS. In fact, there has never been any disease in which so many treatments have been tried. Unfortunately, some of these treatments produce disastrous results. Of all the therapies ever tried, hyperbaric oxygen is the safest, most effective, and most cost effective.
In an initial study by this center, we were able to show that lesions occurring within the brain stem demonstrated by MRI would disappear with one hour of therapy of hyperbaric oxygen, thus reducing any swelling around the lesions. Should Dr. Philip James of the United Kingdom be correct with his embolic theory, this would be a very specific type of therapy for the central nervous system problems of multiple sclerosis.
Lyme Disease is an infectious disease following by a tick infestation with the Borrelia burgdorferi (Bb organism). The disease may remain quiescent for years. When frequently diagnosed, the early signs and symptoms are arthralgia, weakness, fatigue, flu-like symptoms, muscle aches, joint pain, rash (referring to as erythema migrans) and occasional CNS symptoms. Its primary treatment is a tremendous dose of intravenous and oral antibiotics in an attempt to eradicate the parasite.
The effectiveness of any treatment is characterized by a Jarisch-Herxheimer reaction, which occurs when the Bb organisms are somewhat destroyed. The toxic products cause a reaction of fever, chills, and weakness in the patient. The diagnosis remains obscure for a number of years, but recent tests such as the polymerase chain reaction (PCR), the ELISA, or the Western-blot test help to make the diagnosis.
A complicated case of lyme disease is an encephalopathy, or an inflammation of the blood vessels of the brain. This is very well demonstrated with SPECT imaging. We have treated a number of patients with lyme disease who continued intravenous antibiotics, but took hyperbaric oxygenation to help reduce the Bb organism infestation. A herxheimer reaction has been produced and many patients have done well. The original work by Dr. Fife indicated the usefulness of hyperbaric oxygenation in this condition. It must be pointed out that this organism is not an anaerobe but is unable to grow as rapidly in a high oxygen environment.
Cerebral Palsy ( Click here )
Reflex Sympathetic Dystrophy (RSD) is a disease that consists of diffuse persistent pain, usually in an extremity, following a likely local injury. It is diagnosed by a bone scan. This may be frequently dramatic in origin. It is extremely painful and incapacitating. It may involve any part of the body and multiple treatments have been used. Many nerve blocks and multiple pain medications have been given in order to alleviate some of the distress. We have had limited experience with several cases and the results have been remarkable. We had one little girl who arrived in a wheel chair with a chart four inches thick. We were unable to touch her right lower extremity. After three hyperbaric oxygen therapy sessions, the patient was out of the wheelchair; after twenty HBO therapy sessions, the patient was running up and down the beach, and discharged to go home. Her bone scan had returned to normal. The mechanism of action here is not totally understood. It is hopeful that this will evoke more research into the use of hyperbaric oxygen in RSD.
Carbon Monoxide Intoxication can occur from a variety of factors, the most common in the Western World being automobile exhaust poisoning. Carbon Monoxide (CO) takes the place of oxygen (O2) in the blood and the resulting condition, depending on the severity, leads to a lack of oxygenation, or hypoxia.
The Neubauer Hyperbaric Neurologic Center has had success treating late stage carbon monoxide poisoning, in which therapy has been delayed or insufficient. In one case, a patient who had been in coma for over 12 years from carbon monoxide intoxication awoke after oxygen sessions.
Hyperbaric oxygen helps to treat CO intoxication by diluting the concentrations of carbon monoxide and saturating the plasma with sufficient levels of oxygen; thereby preventing hypoxia even in high levels of carbon monoxide. The hyperbaric therapy also will reduce the levels of carbon monoxide in the blood by the large amounts of oxygen; the increase of oxygen parallels an increase in the corresponding compound with hemoglobin.
In many situations the lack of oxygenation leads to brain insult, which we specialize in treating.
Traumatic Brain Injury
Cerebral edema (swelling) is the rise of intra-cranial pressure (ICP) which has serious consequences. This may be frequently associated with severe head injuries or the anoxic and toxic encephalopathies. Studies by the OHNC and others have shown that HBOT, initiated soon after acute closed head injury, can reduce mortality by more than 40%, and substantially increase the possibility of the patient's complete recovery. Recently, close monitoring of cerebral pressure has been extremely effective.
Anoxic Ischemic Encephalophathy
(Near drowning, near hanging)
Every year, more than 150,000 Americans suffer severe head injuries. Like stroke, head injuries deprive certain areas of the brain of oxygen. Again, as in the case of stroke, the damage resembles an atomic bomb blast, with a central core of what is probably irreparable damage surrounded by a penumbra of lesser damage. It is both the size and the location of the initial damage, as well as the reversibility of the damage within the penumbra, that dictates the patient's prognosis. In some cases, this damage can be reversed by HBOT.
But head injury isn't the only cause of brain damage. Every year, thousands of Americans suffer brain damage as the result of near hanging, near drowning, near choking, cardiac arrest, cyanide and carbon monoxide poisonings, and lightning strikes. This type of brain damage is known as an anoxic ischemic encephalopathy.
Brain damage often occurs after a head injury because the brain starts to swell, pressing delicate tissue against the unyielding skull. One researcher found that 80 percent of patients with serious head injuries had brain swelling. This swelling leads to a vicious cycle: the swelling cuts off the brain's blood supply, which leads the accumulation of toxic levels of normal cell wastes. The wastes, in turn, further aggravate the swelling. Such damage can lead to coma, a state of deep unconsciousness in which the patient does not respond to pain or sound, and cannot be awakened. But even under such circumstances, certain brain cells survive in a dormant state within the zone between the damaged and the healthy parts of the brain, a zone called the penumbra.
HBOT can, at times, break this cycle by constricting the brain's blood vessels, yet delivering more oxygen. This seems like a contradiction, but HBOT can increase oxygen levels because the increased pressure forces oxygen into the blood plasma, the liquid part of the blood that normally does not carry oxygen, and into the cerebrospinal fluid that surrounds the brain. The plasma and cerebrospinal fluid can then reach areas that the red blood cells, which normally carry oxygen, cannot penetrate. With HBOT, oxygen in the capillaries is pushed further into the adjacent tissues than when oxygen is administered at standard pressure. HBOT can also stabilize and repair what is called the blood-brain barrier, a protective layer of cells that keeps many toxins or noxious materials from reaching the brain. This barrier is often greatly disturbed when a head injury occurs.
As a result of the extra oxygen that HBOT provides, the dormant brain cells in the penumbra are awakened and begin to function again. Giving a patient pure oxygen at normal pressure simply cannot put enough oxygen into either the bloodstream or the cerebrospinal fluid to overcome the oxygen deficit. But HBOT can improve this oxygen deficiency. Often, this increased oxygenation helps to restore the patient to a conscious state. In certain cases, it also allows the patient to recover from brain damage after effects such as paralysis and speech loss.