For brain injury there is a strong sense that conventional treatment has had little impact on outcome.
The use of HBOT for chronic brain injury is based on the theory that, in any brain injury, there are inactive cells that have the potential to recover. According to this theory, these “idling neurons” exist in the ischemic penumbra, a transition area of dormant neurons between areas of dead tissue and the unaffected healthy tissue.
The oxygen availability to these cells stimulates the cells to function normally, reactivating them metabolically or electrically.
In contrast with the cognitive stimulation theory, the “idling neuron” theory views neuron inactivity denervation as the result of chronic hypoxia and postulates that restoring oxygen stimulates the growth of blood vessels and of new synaptic connections among previously dormant neurons. Supporters of the use of HBOT in brain injury argue that this theory has a stronger experimental base than the theory underlying restorative cognitive therapies.
In children with TBI, the addition of HBOT significantly improved outcome and quality of life and reduced the risk of complications. HBOT for brain injury is not likely to gain acceptance in routine clinical use until a clinical method of assessing its effectiveness in the individual patient is validated.
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