Background Hyperbaric oxygen therapy (HBOT) for the treatment of acute stroke has been under the radar for a long time. Previous studies have not been able to prove efficacy. Several factors might have contributed to such inconsistent results. The timing of delivering the hyperbaric oxygen in relation to the stage of stroke evolution may be an important factor. This was not taken into account in the previous studies as there was no feasible and standardized method to assess the penumbra in the acute phase. Now with the perfusion scan appearing as a key player in the acute stroke management, precise stroke patient selection for hyperbaric oxygen therapy deserves a second chance similar to mechanical thrombectomy. Case presentation A 62-year-old female patient who presented with acute large vessel stroke was not eligible for chemical or mechanical thrombectomy. There was a large penumbra on imaging. She got treated with several sessions of hyperbaric oxygen over a 2-week period immediately after stroke. The patient showed significant improvement on the follow-up perfusion imaging as well as some clinical improvement. The more impressive radiological improvement was probably due to the presence of relatively large core infarction at baseline affecting functional brain areas. The patient continued to improve clinically on her 6-month follow up visit. Conclusion Our case demonstrates immediate stroke-related penumbra improvement associated with HBOT. Based on that, we anticipate a potential role for HBOT in acute stroke management considering precise patient selection. Future randomized controlled trials are needed and should take that in consideration.

中文翻译：

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大半影区急性缺血性脑卒中后高压氧治疗一例

背景 长期以来，用于治疗急性中风的高压氧疗法 (HBOT) 一直备受关注。以前的研究未能证明疗效。有几个因素可能导致了这种不一致的结果。与中风演变阶段相关的高压氧输送时间可能是一个重要因素。之前的研究没有考虑到这一点，因为没有可行和标准化的方法来评估急性期的半影。现在，随着灌注扫描成为急性卒中管理的关键因素，高压氧治疗的精确卒中患者选择值得第二次机会，类似于机械血栓切除术。病例介绍 一名 62 岁女性患者，因急性大血管卒中而无法进行化学或机械取栓。成像有很大的半影。在中风后的 2 周内，她立即接受了几次高压氧治疗。患者在随访灌注成像方面表现出显着改善以及一些临床改善。更令人印象深刻的放射学改善可能是由于基线时存在相对较大的核心梗塞影响功能性脑区。患者在 6 个月的随访中继续临床改善。结论 我们的病例证明了与 HBOT 相关的中风相关半暗带立即改善。基于此，考虑到精确的患者选择，我们预计 HBOT 在急性卒中管理中的潜在作用。需要未来的随机对照试验，并应考虑到这一点。