[Hyperbaric oxygen therapy for neurologic emergency and neurosurgical diseases: a systematic review of the literature].
I have reviewed reports concerning neurologic emergency and neurosurgical diseases adjunctively treated with hyperbaric oxygen (HBO) therapy. Some clinical studies indicate the favorable effects of HBO therapy on the events at an ultra-acute stage of brain ischemia. This therapy has been used in the treatments of other neurologic emergency diseases, such as brain and spinal injury, carbon monoxide intoxication, decompression illness involving the central nervous system and so on. Some reports clarify that patients with malignant gliomas have a prolonged survival by radiotherapy after HBO therapy. In addition, I have applied HBO preexposure to radiosurgical treatments for recurrent and brain stem gliomas. HBO therapy enhances the effects of some chemotherapeutic agents such as platinum drugs and nitrosoureas. Especially, the therapeutic effect of carboplatin, one of platinums, is improved by HBO therapy in recurrent malignant tumors. Although radiation-induced brain injury is the most serious problem after radiosurgery, HBO therapy controls this condition and its progression. Wound infection after intracranial or spinal surgery is well controlled by anti-infectious drugs combined with HBO therapy. Now HBO therapy is an important therapeutic option in the fields of neurologic emergency and neurosurgery. However, high-quality randomized controlled trials that evaluate the short- and long-term risks and benefits of HBO therapy are necessary to better inform clinical decisions.
Kohshi
Kiyotaka
K
Department of Neurosurgery, School of Medicine, Division of Hyperbaric Medicine, University Hospital, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
D001932:Brain Neoplasms / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D004630:Emergencies; D019317:Evidence-Based Medicine; D006801:Humans; D006931:Hyperbaric Oxygenation