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 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
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Figure 1
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Figure 2
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Figure 3
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Figure 4
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Figure 5
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Figure 6
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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.
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