Case report: Treatment of Mild Traumatic Brain Injury with Hyperbaric Oxygen

Col James K. Wright, USAF, MC, SFS; Eddie Zant MD, Kevin Groom PhD, Robert E. Schlegel PhD, PE, and Kirby Gilliland PhD

Two United States Air Force Airmen were injured in a roadside improvised explosive device (IED) blast in Iraq on 13 January 2008. Both airmen suffered concussive injuries and developed irritability, sleep disturbances, headaches, memory difficulties, and cognitive difficulties as symptoms of mild traumatic brain injury (mTBI). Six months after injury, repeat Automated Neuropsychological Assessment Metrics (ANAM) testing showed deterioration, when compared to pre-injury baseline ANAM assessment, in all measured areas (simple reaction time, procedural reaction time, code substitution learning, code substitution delayed, mathematical processing, and matching to sample). The airmen were treated with hyperbaric oxygen (HBO) in treatments of 100% oxygen for one hour at 1.5 atmospheres absolute resulting in rapid improvement of headaches and sleep disturbances, improvement in all symptoms and resolution of most symptoms. Repeat ANAM testing after completion of the hyperbaric treatments, nine months after initial injury, showed improvement in all areas, with most measures improving to pre-injury baseline levels. The airmen received no other treatment besides medical monitoring. Repeat neuropsychologic testing confirmed the improvement. We conclude that the improvement in symptoms and ANAM performance is directly attributable to the HBO treatment.