Hyperbaric
Oxygen Therapy and Stroke
Today
it is estimated, stroke outranks head injuries as the leading cause
of neurological disability in North America. Each year, hundreds
of thousands of families experience the ravages of stroke by a family
member.
In
Dr. Neubauer's book Hyperbaric Oxygen Therapy he states one third
of those who suffer a stroke do not survive the initial attack,
and another third enter nursing homes. Only one third improve, and
many of these patients are left with disabilities that hinder their
capacity to resume their pre-stroke lives. He further states that
stroke care in the USA cost more than $30 billion a year. We can
usually take USA figures and divide by 10 to get a fairly accurate
estimate of the costs here in Canada.
HBOT
cannot help all stroke patients who are seeking improvements but
it does offer many the chance to improve or reverse some symptoms
if the damage, which has been done, is not severe or in critical
area.
The
majority of strokes are caused by blood vessel obstructions, such
as blood clots, that cut off blood and oxygen to parts of the brain.
This results in the death of brain cells if the flow of blood is
not restored within a few minutes. The localized non-functioning
area in the brain is called an infarct. Previously healthy tissues
surrounding the infarct start to become hypoxic, which is referred
to as the ischemic penumbra. It contains dormant or idling neurons,
brain cells that are nonfunctional but intact.
The
disabilities that ensues depends upon what area of the brain has
been affected. They may include paralysis on one side of the body
and spasticity. This damage to the brain can reduce mobility, speech,
swallowing ability, create mental difficulties, memory loss and
personality changes.
With
the use of HBO, the dormant neurons restore their metabolism and
function and the patient has a good chance of recovering some function
which can be very significant. Sometimes, one part of the brain
can take over the function of another part of the brain. The brain
starts to sort out and reorganize function. This ability to switch
functions is call plasticity.
Some
people have spontaneous improvement and if the damage is not severe
can recover partial if not all their function on their own. HBOT
is used to ensure that as much recovery to the idling , intact brain
cells take place and offers a more optimistic outlook for stroke
patients.
HBOT
decreases swelling in brain tissues, relieves oxygen starvation
known as hypoxia, improves micro circulation and reduces spasticity.
The improvements seen in patients have been reproduced in hyperbaric
centres worldwide. Skeptical physicians who have followed their
stroke patients recovery using HBOT, soon become convinced of the
positive physiological changes their patients have undergone.
The
use of double blind studies in the case of stroke victims has an
ethical dilemma. How to treat some patients and not others knowing
that the patients given placebo treatments could have improved if
they were able to have HBO treatments. In this case the records
of previous stroke patients progress could be used or the stroke
patient themselves used as their own control.
Positive
effects using HBOT, have been recorded in many studies worldwide.
Whether a patient is seen within the first 24 hours after a stroke
or 10 years later, recovery of non functioning dormant cells have
been seen. HBOT does not resurrect dead brain tissue but it does
assist the wound healing capabilities in the brain which is not
available with any other form of therapy. The oxygenated neurons
gradually reconnect to the rest of the brain helping to return the
use of lost cerebral and bodily functions.
HBOT
in conjunction with other modes of therapy have given physicians
a powerful tool with which to help their patients recover to the
best of their ability. Some patients return to work while others
are able to regain functions which will allow them to stay at home
with limited assistance to living entirely independently.
This
centre has seen good recoveries in all the stroke patients we have
treated. All patients are seen by our hyperbaric physician before
starting HBOT and any necessary tests and previous health history
examined. A video from Dr. Paul Harch on the science behind the
physiological changes which occur in stroke patients using HBO may
be obtained from this centre to view or to pass on to your primary
care physician. It must be noted that most physicians are not aware
of the science behind hyperbarics and will not know what to advise
their patients until they either see patients improvement themselves.
Since there are few absolute contraindications, HBOT under the care
of our physicians is safe and can be life changing.
Jain
K.K. Journal of Hyperbaric Medicine,4;55-61, 1989 Effect of hyperbaric
oxygenation on spasticity in stroke patients.
Neubauer
RA and Gottlieb SF. Stroke treatment Lancet 337;1601,1991.
Kaasid
AE., Dimitriev KK., and Tomberg TA. Hyperbaric oxygenation in the
treatment of patients with ischemic stroke. Zh Nevropatol Psikhiatr
88:33-43, l988.
Whalen
R., HeymanA., and Saltzman H. The protective effect of hyperbaric
Oxygen in cerebral Ischemia. Arch Neurol 14:15, l966.
Neubauer
RA., Kagan RL., Gottlieb SF., and James. PB. Letter to the Lancet,
March 3, l990.
Neubauer
RA., Gottlieb SF., and Kagan RL. Enhancing "idling" neurons.
Lancet 335-542, l990.
There
are many references and research article on stroke and the use of
HBO which can be obtained at any medical library or by searching
the internet.
An
important book to read is Hyperbaric Oxygen Therapy by Richard A.
Neubauer, M.D. and Morton Walker, DPM.

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