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Biochemical response to hyperbaric oxygen treatment of a transhemispheric penetrating cerebral gunshot injury

Frontiers in Neurology (2015) 6(MAR)
DOI: 10.3389/fneur.2015.00062
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Abstract

Hyperbaric oxygen (HBO) therapy has been suggested a treatment option in order to reduce the development of secondary insults succeeding traumatic brain injury. This case report studied the course of a 23-year-old gentleman with a close range transhemispheric gunshot wound. The biochemical parameters, using a multi-modal monitoring in the neuro-intensive care unit, improved following HBO treatment.

Figures

  • FIGURE 3 | Post-operative CT (after hemicraniectomy) day 2. The white arrows highlight the hypodense regions of brain parenchyma in the posterior circulation which is tissue at risk for subsequent ischemic injury.
  • FIGURE 1 |The admission CT-scan, (A) highlights the bone fragments close to the entry point behind the right ear (ring). (B) Illustrates the bullet (ring) and its trajectory (arrows).
  • FIGURE 2 | Illustrating how the lactate:pyruvate ratio (LPR, black), the central perfusion pressure (CPP, blue), the intracranial pressure (ICP, green), and S100B (red) levels changed over time. The first red arrow indicates the time for hemicraniectomy (“surgery”) while the other three highlight the timings for HBO treatment.
  • FIGURE 4 | Lactate:pyruvate ratio (LPR, black), intracranial pressure (ICP, blue), and the brain tissue oxygen pressure (PBtO2, red) changes during HBO treatment (red blocks).
  • FIGURE 5 | Illustrating how the brain tissue oxygen pressure (PBtO2, black), the arterial blood gas oxygen pressure (pO2, red), and fraction of inspired oxygen (FIO2, blue) changed over time. The red arrows indicate timing for HBO treatments. All the measurements presented are performed at normobaric conditions (before and after HBO).
  • FIGURE 6 | MRI performed [susceptibility weighted imaging protocol (SWI)] on day 16 after injury reveals bilateral temporal damage and hemorrhage along the bullet, yet no signs of ischemic injury.

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CITATION STYLE

APA

Thelin, E. P., Bellander, B. M., & Nekludov, M. (2015). Biochemical response to hyperbaric oxygen treatment of a transhemispheric penetrating cerebral gunshot injury. Frontiers in Neurology, 6(MAR). https://doi.org/10.3389/fneur.2015.00062

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