Journal of Hyperbaric Medicine, Vol 6, No 3, 1991
Coma / Encephalopathy
This study illustrates the value of oxygen therapy Hyperbaric Oxygen Therapy Leading to Recovery of a 6-Week Comatose Patient Afflicted by Anoxic Encephalopathy and Posttraumatic Edema.
I. Eltorai and R. Montroy Spinal Cord Injury and Surgical Services, Veterans Affairs Medical Center, Long Beach, California, and University of California College of Medicine, Irvine, California.
Case Report: The patient was a 58-yr-old white male veteran, an incomplete quadriplegic at C5-C6 level secondary to a diving accident in 1952, and an efficient, intelligent, and active person. On 3 November 1987, while getting into his van on a lift, he fell from the height of the van lift sustaining a right eyebrow incised wound with concussion. He was unable to remember the fall or how he got into the emergency room. While in the CT scan he became confused and nonresponsive and developed respiratory arrest. He was resuscitated and intubated with slight difficulty and he bit the tube for 2-3 min. Initial CT scan showed no bleeding and no shifts Neurologic exam showed a comatose patient on a ventilator without response to any stimuli and was classified at GCS score 3. The patient's neurologic status did not change and he was kept on supportive treatment until 21 December 1987, when one of us (I.E.) saw the patient. HBO was tried at 2 atm abs for 90 min daily using a Sechrist monoplace chamber and a Sechrist ventilator. On the first session, the patient was restless, opened his eyes, turned his head from side to side, and responded to sounds. On the second day, he responded sometimes to his name. Day 3: in addition, moving the upper limbs; Day 4 responds to names Day 5 same, Day 6 same Day 7 alert, responds to verbal stimuli; Day 8 same; Day 9 responds to name and verbal command; Day 10 as above, but looking around; Day 11 as above. The patient continued to respond to commands at first by shaking his head or nodding until session 24 when he started talking, though only briefly, and gradually ate his meals without problems. Then he started to complain ...
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