Recommendations for hyperbaric oxygen therapy for diffuse axonal injury

  Diffuse axonal injury is a closed cranial injury. With the development of imaging technology, especially MRI technology, more patients have an imaging basis to be diagnosed as “diffuse axonal injury”.  In 2001, in a consultation at another hospital, a patient with diffuse axonal injury was in a coma, but the MRI films did not show the contusions, hematomas, and subarachnoid hemorrhages that are usually seen in patients with traumatic brain injury, so it seemed that the clinical presentation did not match the imaging. The neurosurgery department had no further treatment measures for the condition at that time and was referred to our department for hyperbaric oxygen therapy. At that time, there were few academic papers of this kind, and many clinicians were not aware of this diagnosis. The available reports said that “diffuse axonal injury” had a mortality rate of more than 80%, and there were almost no reports of sobriety, let alone reports of hyperbaric oxygen therapy. We treated the patient with intermittent hyperbaric oxygen therapy, with passive rehabilitation and active rehabilitation between treatments. After two months of hyperbaric oxygen + rehabilitation treatment the patient gradually became conscious and regained the ability to live on his own. Many patients have been treated and rehabilitated in our hospital since then. Most of them were injured by car accidents and falls from height. In recent years, hyperbaric oxygen therapy for diffuse axonal injuries has been recognized by many hospitals and doctors. The search terms of diffuse axonal injury and hyperbaric oxygen can be found in nearly 200 related articles in China’s largest academic journal website “China Knowledge Network”.  Diffuse axonal injury is a serious brain surgery condition, where the patient is unconscious and unable to eat, and all life support depends on human care and medical support. Scientific and rational intake, caloric, acid-base and electrolyte balance, prevention of pressure sores, and prevention of deep vein thrombosis are equally important. Because patients are bedridden for a long time, respiratory and urinary tract infections are important factors threatening their lives. The organic combination of hyperbaric oxygen therapy and rehabilitation therapy is an important part to help patients recover their life and working ability as soon as possible.