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Decompression - SPECT Imaging, HBOT and Chronic Traumatic Brain Injury

 

 

SPECT Imaging, HBOT and Chronic Traumatic Brain Injury

 

  HBOT in Decompression Illness & Air Embolism

These were the seminal diagnoses in which Dr. Harch discovered in divers and confirmed Dr. Neubauer's hypothesis that HBOT is effective in the treatment of chronic brain injury. To this day these diagnoses remain the most amenable to delayed treatment with HBOT of nearly all of the cerebral neuropathologies due to peculiarities of the underlying pathology. In 1990 Dr. Harch treated the first case. By 1995 there were over 20 cases, 15 of which were reported at the 45th UHMS Workshop on Treatment of Decompression Illness (27). Below is a case published in the 1996 Second Edition of K.K. Jain's Textbook of Hyperbaric Medicine (28) and presented at the 1993 UHMS Meeting (29).

Case Presentation:

The patient is a 49 year old male diver who presented with hearing loss, ringing in the ears, decreased cognition, imbalance, disturbed gait, and extreme irritability one month after a series of 12 dives in the Caribbean. The patient underwent SPECT brain imaging before and after his fourth HBOT (Figures 1 and 2, respectively) and after over 60 HBOT's (Figure 3) which showed smoothing of the patchy heterogenous pattern and an overall increase in brain blood flow which paralleled near complete resolution of his signs and symptoms. Notice also the normalization of flow to the cerebellar lobes on the lowest row. Figures 4, 5, and 6 are three dimensional surface reconstructions of Figures 1, 2, and 3 looking at the patient's brain face-on.

Click Image to Enlarge
Figure 1
Figure 2
Figure 3
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Figure 3
 
 
 
Figure 3
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Figure 6
 

27. Harch PG. Late treatment of decompression illness and use of SPECT brain imaging. 45th Undersea and Hyperbaric Medical Society Workshop, Treatment of Decompression Illness, eds. RE Moon, PJ Sheffield. June 18-19, 1995, Palm Beach, Florida, Undersea and Hyperbaric Medical Society, Kensington, MD, 1996.

28. Harch PG, et al. Use of HMPAO SPECT for assessment of response to HBO in ischemic/hypoxic encephalopathies. Appendix, Textbook of Hyperbaric Medicine, 2nd Edition, 480-491. K.K. Jain, editor. Hogrefe and Huber Pubs., Seattle, 1996.

29. Harch PG, et al. Delayed treatment of type II DCS: the importance of low pressure HBOT and HMPAO SPECT brain imaging in its diagnosis and treatment. Undersea and Hyperbaric Medicine, 1993;20(Suppl):51.

HBOT - SPECT Imaging

The obvious effects of HBOT treatment can be seen if only a few sessions.


3. Harch PG, et al. HMPAO SPECT brain imaging and low pressure HBOT in the diagnosis and treatment of chronic traumatic, ischemic, hypoxic and anoxic encephalopathies. Undersea and Hyperbaric Medicine, 1994;21(Suppl):30.

28. Harch PG, et al. Use of HMPAO SPECT for assessment of response to HBO in ischemic/hypoxic encephalopathies. Appendix, Textbook of Hyperbaric Medicine, 2nd Edition, 480-491. K.K. Jain, editor. Hogrefe and Huber Pubs., Seattle, 1996.

30. Barrett KF, Masel BE, Harch PG, et al. Cerebral blood flow changes and cognitive improvement in chronic stable traumatic brain injuries treated with hyperbaric oxygen therapy. Neurol, April, 1998 (Suppl):A178-A179.