The Use of Hyperbaric Oxygen to Increase the Blood Supply in the Injured, But Still Alive Tissue, Around an Old Stroke

Most patients who suffer an acute ischemic stroke improve over the immediately ensuing 30-90
days. However, many patients do not improve beyond this initial period in spite of continued
intensive physical therapy and supportive care. A prospective, randomized trial of the use of
hyperbaric oxygen treatments in 59 such patients was published in January 2012. That study
which used 40 hyperbaric oxygen treatments, indicated significant clinical neurological
improvement in residual motor deficit in patients who had sustained a stroke over a year
previously. An increase in brain activity in the region immediately surrounding their stroke
(penumbra) was reported on the basis of SPECT studies. Regions of live cells were determined
by CT. Because SPECT is primarily a measure of perfusion and not metabolic activity and CT is
a poor measure of cell life, the investigators plan to assess areas of physiologic/anatomic
mismatch in similar patients following hyperbaric oxygen treatment by the use of the more
appropriate and precise tools, PET and MRI.

Inclusion Criteria:

- person must have sustained an acute ischemic stroke 6-12 months prior to enrollment,
exhibited clinical improvement during the initial 30-90 days post stroke, exhibited no
further improvement for at least 1 month in spite of continued supportive care and
physical therapy, must have at least one residual measurable motor deficit.

Exclusion Criteria:

Smoking, Contraindications to an MRI e.g. pacemaker, Contraindications to hyperbaric oxygen
treatment e.g. emphysema, claustrophobia. seizure disorder, Inability to tolerate
pressurization e.g. Eustachian tube dysfunction, other uncontrolled co-morbidities e.g.
diabetes, hypertension, thyroid disorders, renal or hepatic dysfunction.