Can Hyperbaric Oxygen Be Used For Brain Injury Treatment?

//Can Hyperbaric Oxygen Be Used For Brain Injury Treatment?
  • Doctor with brain scans preparing for hyperbaric treatment for brain injury.

Anything inside the skull can be challenging to treat, and neural damage and healing can be unpredictable. This is exactly why hyperbaric oxygen therapy (HBOT) has had such an appeal over the years. It’s non-invasive, has body-wide benefits, and has been easy to tolerate.

If you or someone you love has experienced brain injury, you know the devastation it causes. Care is intensive and often palliative.1

Several studies have shown positive outcomes for HBOT for traumatic brain injury,2 toxic brain injuries like carbon monoxide & cyanide poisoning, and decompression sickness.

What happens when the brain is injured?

Lack of oxygen is typically the crux of any kind of brain injury.3 Both traumatic brain injury and acquired brain injury are either created by or lead to this problem.

Traumatic brain injuries are structural damage that leads to cellular damage. Loss of blood, tissue tearing, and swelling quickly compress the fragile brain tissue in the space-limited skull. Traumatic brain injuries include concussions, contusions (blood leaking from injured vessels), diffuse axonal injury (tearing from a brain-twisting), and penetration injuries. This trauma rarely comes alone. Head wounds, scalping, bruising, and skull fractures commonly accompany them.

Acquired brain injuries come from the inside, rather than the outside. This includes strokes, tumors, near-drowning, toxins, and degenerative diseases. The brain injury is usually caused by hypoxia or anoxia. With hypoxia, the brain receives some, but not enough oxygen. With anoxia, it doesn’t receive any. This can be because blood is not carrying oxygen, oxygen is getting blocked, or blood flow is getting blocked/reduced.

How can hyperbaric oxygen therapy for brain damage help?4

  • HBOT increases oxygenation. Brain tissue needs more oxygen than any other tissue in the body, after the liver. It uses just over 18% of all oxygen you breathe.5 It’s one of the first organs to suffer during a hypoxic crisis. Restoring oxygen becomes a primary need.
  • HBOT suppresses inflammation. Oxygen helps reduce cytokine production, which triggers the production of inflammation.6 The head can only tolerate so much pressure, making this an especially useful feature.
  • HBOT decreases apoptosis. This is where the cell self-destructs or dies. Generally, the body has a regulated system of cell death.6 But, with some brain injuries, the process gets sped up.
  • HBOT reduces intracranial pressure (ICP). ICP creates great amounts of brain injury by overcrowding the skull’s limited space. The brain gets easily compressed even with a small amount of swelling, blocking circulation and damaging tissue. Several cases have shown a reduction in ICP with hyperbaric oxygen therapy.7
  • HBOT promotes the new development of neurons and blood cells.8 When limited blood flow is the key problem, the body gets stuck in a self-destructive loop. The body can’t make blood vessels without oxygen—and blood vessels usually are the ones to deliver oxygen. HBOT bypasses this need by pushing oxygen straight to the tissues.

Will insurance cover HBO treatment for my brain injury?

It depends. Currently, HBOT is approved for Medicare coverage for less than 15 diagnoses.9 Because the high cost of a full length of therapy, self-pay is uncommon.

But, while insurance may not cover the specific injury, a brain injury may come with other problems that ARE covered. There are several other diagnoses that may qualify for HBOT including:

  • A failed graft. If a patient has had a brain injury requiring surgery or had a traumatic accident that has scalped the head, a graft may be inevitable. A failed graft is when a graft doesn’t successfully adhere to the site it was applied to.
  • Bone death from radiation. Cancer treatment, especially to the head and neck, can have terrible side effects. Brain injury is one, but sores leading to bone death are another.
  • Cyanide poisoning. Cyanide comes from smoking cigarettes, several manufacturing industries, and some natural processes. When breathed in or ingested, it keeps cells from using oxygen, which makes them die. This can quickly create brain injuries like convulsions, weakness, loss of consciousness, slow heart rate, and low blood sugar.10
  • Acute carbon monoxide poisoning. Carbon monoxide has a very similar structure to oxygen. When inhaled, it can ride on the hemoglobin that normally carries oxygen to your cells. Your cells can’t use carbon monoxide, so they become oxygen-starved.
  • Some lower extremity diabetic wounds. Diabetes is a risk for brain injury.11 High blood sugars can cause both the brain tissue and tissues of the legs and feet to deteriorate.
  • Radiation-related tissue damage. Cancer treatment to the head usually comes with its own problems. Radiation-induced brain injury is a serious side effect.12 This damage also includes radiation-related tissue damage (sometimes called “radiation burns”). If that’s persisting over 6 months after treatment, you may be able to qualify for HBOT.
  • Decompression sickness. This illness, from overly fast decompression, can have stroke-like symptoms. Difficulty breathing, numbness, tingling, weakness, vertigo, and chest pain come from the nitrogen bubbles that affect the brain and spinal cord.13

Is hyperbaric oxygen therapy possible for emergency treatments of traumatic brain injury?

Not in many cases. This will largely depend on the injury and your most emergent need. HBOT is time-intensive. Also, compared to other interventions, it isn’t the fastest emergency treatment. Strokes, concussions, comas, and other traumatic brain injuries will likely need another treatment as a first response.

If a brain injury requires surgery or emergency medications, HBOT would not be an appropriate first intervention. However, HBOT could be appropriate for cyanide poisoning and acute carbon monoxide poisoning. This would be up to your emergency provider.

It would also depend on how near you are to a facility with hyperbaric chambers. Not all hospitals have these chambers. Also, many facilities with chambers are not equipped or qualified to handle emergency HBO “dives.”

Looking to talk to a specialist about getting HBOT for brain injury side effects?

If you’re interested in HBOT for a brain injury, or a brain injury side effect, the best next step is to talk about it with a specialist. Let’s discuss your needs, and whether HBOT would be a good choice for your care plan. Speak with someone at the Hyperbaric Physicians of Georgia by calling 770-422-0517. You can also complete our contact form. We look forward to speaking with you!

References:

  1. https://www.psychiatrictimes.com/view/treatment-traumatic-brain-injury-hyperbaric-oxygen-therapy
  2. https://pubmed.ncbi.nlm.nih.gov/18642650/
  3. https://biau.org/types-and-levels-of-brain-injury/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5110132/#:~:text=One%20of%20the%
    20important%20mechanisms,et%20al.%2C%201988
    )
  5. https://science.jrank.org/pages/856/Biochemical-Oxygen-Demand.html#:~:text=The%20major%20single%2Dorgan%20oxygen,skeletal%20muscles
    %20consume%20about%2020%25
    .
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1808843/#:~:text=In%20some%20models
    %2C%20HBO%20could,granulocytic%20cell%20lines%20%5B18%5D
    .
  7. https://pubmed.ncbi.nlm.nih.gov/1723171/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231808/
  9. https://www.medicare.gov/coverage/hyperbaric-oxygen-hbo-therapy
  10. https://emergency.cdc.gov/agent/cyanide/basics/facts.asp
  11. https://pubmed.ncbi.nlm.nih.gov/28276776/
  12. https://academic.oup.com/noa/article/2/1/vdaa057/5830782
  13. https://www.merckmanuals.com/home/injuries-and-poisoning/diving-and-compressed-air-injuries/decompression-sickness#:~:text=Decompression%20sickness%20is%20a%20disorder,pain%20in%20muscles%20and%20joints

[This article should not replace medical advice from a physician. We do not guarantee or imply that you can or cannot get insurance coverage of any kind for your condition.]

By | 2021-04-09T10:50:45-04:00 December 18th, 2020|Hyperbaric Oxygen Therapy|0 Comments

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During this pandemic, we will try and minimize risks to patients and staff. Guidance changes frequently, so we may need to change our recommendations over time.

We ask that all patients come into the office wearing a mask. Masks may be removed at the instruction of the staff for hyperbaric oxygen therapy.

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