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

Colonel James K. Wright1, Eddie Zant2, Kevin Groom3, Robert E. Schlegel4, Kirby Gilliland4 1720th Special Tactics Group, Hurlburt Field, Florida, USA; 2Hyperbaric Medicine Inc., Fort Walton Beach, Florida, USA; 3The Anchor Clinic, Destin, Florida, USA; 4Center for the Study of Human Operator Performance, The University of Oklahoma, Norman, Oklahoma, USA Undersea and Hyperbaric Medical Society Inc. 2009, Vol. 36, No. 6

Summary Two United States Air Force Airmen were injured in a roadside improvised explosive device (IED) blast in Iraq in 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 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 most likely attributable to HBO treatment.

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