Understanding How HBOT Works to Help Stroke Patients
How HBOT Works To Help Stroke Patients
HBOT works by improving blood flow to a stroke patient’s damaged brain tissues. The area of dead brain tissue resulting from a lack of blood supply is known as an infarct. The ability of a stroke victim to recover using hyperbaric oxygen and HBOT (or any other medical treatment) depends on several factors: the infarct size and location and the condition of the penumbra (the area between dead tissues and the non-impacted brain). Severe brain infarctions cause swelling that also intensifies pressure on the remaining viable brain tissue.
Higher Oxygen Levels Make a Difference
Hyperbaric oxygen therapy floods blood plasma, lymph fluids and cerebrospinal fluid (the clear, watery fluid that fills the brain and spine) with pure oxygen at higher than normal atmospheric pressures. The body receives 1,500 to 2,000 times the O2 concentration it would when a person breathes in normal room air. This brings down brain swelling and provides crucial nutrients to oxygen-starved brain matter, muscle and bone. In many cases, with a series of hyperbaric oxygen and HBOT treatments, stroke victims’ function improves. Dormant cells in the penumbra become reactivated, and new capillaries also form in the area. These capillaries increase both blood flow and nutrients and carry away cellular waste.
Studies Show the Effects of HBOT for Stroke Patients
Numerous studies have looked at the effectiveness of HBOT treatments on stroke patients and have found amazing results. In 2013, Dr. Shai Efrati of Tel Aviv University’s Sackler Faculty of Medicine and fellow researchers showed conclusively in a randomized trial study that high oxygen levels can reinvigorate dormant neurons. The study’s participants included 74 patients between six months and three years’ post-stroke, whose condition was no longer improving. Researchers split participants into two groups – one that got HBOT from the beginning of the study, and the second that got no treatment for two months then received a two-month period of HBOT treatment. Researchers used a combination of CT scans to identify dead tissue areas and SPECT scans to measure the metabolic activity level of neurons that surrounded damaged brain areas.
Brain imaging showed significantly increased neuronal activity after a two-month period of HBOT treatments for two hours five times weekly, compared to control periods of non-treatment. Patients saw dramatic improvements that included reversing paralysis, increased sensation and a renewed ability to use language. And although the study focused just on patients up to three years’ post-stroke, similar improvements reported in patients whose brain injury occurred up to 20 years before!
Current Studies Show Promise for HBOT and Stroke Patients
There are currently two active studies looking at the effects of HBOT on ischemic stroke patients. The first study is by the University of British Columbia and began in 2015. It is looking at 140 patients that are three to 36 months post-stroke. Half of the participants will receive HBOT while the other receives normal air. This study’s planned end date is December 2019. The second study is b by Kasr El Aini Hospital is looking at 60 patients within 48 hours of suffering an ischemic stroke. Of these 60 patients, 30 will receive conventional medical treatment while the other 30 will receive conventional treatment along with 10 HBOT sessions within three to five days of the stroke. This study’s planned end date if June 2020.
If you are interested in finding out how HBOT can help you regain quality of life after a stroke, contact our office today to set up an initial consultation. You may also visit HERE and fill out our contact form and our office staff will contact you.
What is a Stroke and What Are the Symptoms?
A stroke, or cerebrovascular accident (CVA), occurs when normal blood circulation and oxygenation within the brain stops due to blood clots or cerebral hemorrhaging. This lack of blood flow and oxygenation caused brain neurons to die quickly, resulting in a loss of brain and body function. According to the Centers for Disease Control and Prevention, every year nearly 800,000 people suffer from a stroke. Immediate treatment after a stroke is essential in order to minimize brain damage, complications, or death. If you are having a stroke, you may experience:
- Difficulty Speaking and Understanding – A person who is having or has had a stroke may experience confusion. Words may slur, they may not be able to find the right words to express what they are trying to say, or they may have difficulty understanding what is being said to them.
- Numbness or Paralysis in the Face, Arms or Legs – This typically happens on one side of the body. You may experience numbness, weakness, or complete paralysis. If you suspect a stroke, try raising your arms above your head. If one arm starts to drop, you may be experiencing a stroke.
- Headache – A sudden and severe headache that can cause vomiting, dizziness or loss of consciousness.
- Instability – You may experience unexplained dizziness, loss of balance or a loss of coordination.
- Vision Changes – A stroke can affect your vision, often causes blurred or double vision. You may experience darkened or a loss of vision in one or both eyes.
- Drooping Mouth – People having a stroke may notice that when they smile or talk, on side of their mouth droops.
The F.A.S.T acronym was created to remind people what signs to look for in a potential stroke victim. F for face drooping, A for arm weakness, S for speech difficulty and T for time to call 911.
Types of Strokes
There are three main types of strokes, each determined by how the blockage of blood flow and lack of oxygen occurred. These types are:
- Ischemic Strokes – Around 80 percent of all strokes are ischemic. They occur when blood vessels that supply the brain become narrowed or blocked. This disrupts the flow of blood to the area. There are two main types.
- Cerebral Embolism – This occurs when a clot develops somewhere else in the body, often within the heart. It breaks free and travels through the bloodstream and into the brain. Here they are too small for it to pass through.
- Cerebral Thrombosis – Here, a thrombus, or blood clot, forms in one of the arteries that supply the brain. This clot can be the result of fatty deposits built up in the artery.
- Hemorrhagic Strokes – These occur when a blood vessel in the brain ruptures or leaks and they account for around 13 percent of all strokes. Causes include hypertension, too high a dose of anticoagulants, or brain aneurysms. Types of hemorrhagic strokes include:
- Intracerebral Hemorrhage – This occurs when a blood vessel in the brain ruptures and fills the area surrounding the brain tissue. This creates pressure and causes brain cells to die.
- Subarachnoid Hemorrhage – These occur when an artery near the base of the brain burst and fills the space between the brain and the skull. These types of strokes often produce a severe headache.
- Transient Ischemic Attacks (TIA) – TIAs are considered mini or warning strokes. Like ischemic strokes, mini clots create a temporary blockage, resulting in no permanent damage. Symptoms come on quickly and typically resolve within one to five minutes.
Complications of Strokes
How much damage strokes create depend on how long the brain goes without blood flow and oxygen. Additionally, it depends on what part of the brain receives damage.
Patients may experience no long-lasting symptoms while others may experience complications such as:
- Paralysis and Loss of Muscle Control – A stroke can result in paralysis, typically on one side of the body. In addition, immobility can increase the risk of developing blood clots in the deep veins of the legs. Being immobile can also lead to muscle weakness and loss of flexibility.
- Dysarthria – This is the inability to speak or talk clearly. This is common if the stroke affects muscles in the mouth and throat.
- Dysphagia – Dysphagia describes the difficulty in swallowing. This can make eating difficult as well as make you feel as though you have something stuck in your throat.
- Aphasia – Aphasia is the loss of ability to understand and express speech. As a result, this can affect conversation, reading, and writing.
- Memory Loss or Difficulty Thinking – Memory loss and difficulty with thinking, reasoning, and understanding simple concepts or directions.
- Changes in Emotions – Controlling emotions may become difficult. Many patients suffer from depression after a stroke.
- Pain – Pain or changes in sensation can occur depending on where the body is affected by the stroke. Patients can experience numbness, tingling, pins and needles, and extreme sensitivity to temperature changes.
- Loss of Bowel and Bladder Control – Some strokes can affect the muscles responsible for controlling bowel and bladder function. In this case, many patients may require a catheter.
- Loss of Self-Care Ability – Many patients can no longer care for themselves and, as a result, require daily help.
Traditional Treatments for Stroke
A stroke is considered a medical emergency and treatment needs to begin as soon as possible. What treatment you receive depends on which type of stroke you suffered. The immediate goal of treatment with an ischemic stroke is to break up the clot blocking the arteries supplying blood to the brain. If the patient arrives at the hospital within four hours of symptom onset, doctor’s will administer a tissue plasminogen activator (tPA) into a vein in their arm. This drug is a clot-dissolving medication. If the patient arrives after four hours, antiplatelet or anticoagulant medication tries to thin the blood and prevent additional clots from forming. If the cause was carotid artery disease, doctors may recommend a carotid endarterectomy or carotid angioplasty to open the blocked arteries.
Hemorrhagic strokes must be treated differently. Anticoagulants or antiplatelet medications would make bleeding worse. If high blood pressure is the cause of the bleed, medication may be prescribed to prevent further bleeding. Surgical intervention is often necessary for hemorrhagic strokes. Those procedures are aneurysm clipping and coil embolization.
Our Post Stroke Treatment Center
At the National Hyperbaric Oxygen Therapy Center, we offer treatments to supplement HBOT. These include prescription meds to decrease limb spasms, Botox injections to reduce spasticity, and other medications to lessen the chance for a further stroke, such as Plavix, Aggrenox, Ticlid, Coumadin, and aspirin. We also offer Physical Therapy to supplement HBOT’s effects. Orthopedists prescribe physical therapy to restore muscle strength and joint motion following a bone break or fracture. Similarly, stroke patients require both hyperbaric oxygen therapy, or HBOT, and physical therapy to regain strength and mobility, as well as to stabilize weakened limbs.
During hyperbaric oxygen therapy at our Post Stroke Treatment Center, we frequently see patients progress from wheelchair confinement to walking with assistance. Some progress from walkers to canes – or even now walk completely unassisted. Other patients find their slurred speech improves so much that they’re able to resume gainful employment. We celebrate each victory as we watch a patient’s self-esteem, dignity, and economic stability return.
Take the Next Step Today!
As part of a versatile treatment approach, hyperbaric oxygen therapy can restore purpose and function to stroke victims’ lives. And that’s very important, both for them and for us!
For more information about hyperbaric oxygen, HBOT, and our Post Strokes Treatment Center, please contact our office today at 727.787.7077 to schedule a consultation. Dr. Spiegel and his team will evaluate your medical history and work to create a treatment plan just for you.