Traumatic Brain Injury (TBI)

TBI is called the silent epidemic of the US.  Of the two million people who suffer a TBI each year about 1 million go to the emergency room, half a million are hospitalized and 50,000 die. Ischemia is the major cause of secondary brain injury and death following TBI.

The costs amount to about $56 billion. The use of HBO in the treatment of TBI has been controversial.  Off and other safety concerns have been front and center.85

Historically, HBO was seen as a mechanism to decrease cerebral blood flow and intracranial pressure while increasing oxygen availability to injured brain cells.  HBO also appears to be working at the mitochondrial level to improve cerebral aerobic metabolism after brain injury.  Clinically, HBO has been shown to decrease mortality rates and improve functional outcome in severely brain-injured patients.

Acute head injury is a significant cause of premature death and disability.  Each year, there are at least 10 million new head injuries worldwide.  These account for a high proportion of deaths of children and young adults.  Two percent of the population of the U.S. (5.3 million people) are living with disability as a result of TBI.  Major causes are car crashes, falls and violence.  The rate of long-term disability puts a heavy social, medical and financial burden on society.

Therapy focuses on prevention and/or minimization of secondary injury.  There is good logic for the use of HBOT for TBI.

85Zhang, 173.