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Hyperbaric Oxygen for Cerebral Vasospasm and Brain Injury Following Subarachnoid Hemorrhage

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Abstract

The impact of acute brain injury and delayed neurological deficits due to cerebral vasospasm (CVS) are major determinants of outcomes after subarachnoid hemorrhage (SAH). Although hyperbaric oxygen (HBO) had been used to treat patients with SAH, the supporting evidence and underlying mechanisms have not been systematically reviewed. In the present paper, the overview of studies of HBO for cerebral vasospasm is followed by a discussion of HBO molecular mechanisms involved in the protection against SAH-induced brain injury and even, as hypothesized, in attenuating vascular spasm alone. Faced with the paucity of information as to what degree HBO is capable of antagonizing vasospasm after SAH, the authors postulate that the major beneficial effects of HBO in SAH include a reduction of acute brain injury and combating brain damage caused by CVS. Consequently, authors reviewed the effects of HBO on SAH-induced hypoxic signaling and other mechanisms of neurovascular injury. Moreover, authors hypothesize that HBO administered after SAH may “precondition” the brain against the detrimental sequelae of vasospasm. In conclusion, the existing evidence speaks in favor of administering HBO in both acute and delayed phase after SAH; however, further studies are needed to understand the underlying mechanisms and to establish the optimal regimen of treatment.

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Acknowledgments

This study is partially supported by grants from National Institutes of Health: NS53407, NS43338, and HD43120 to J.H. Zhang.

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The authors declare no conflict of interest pertaining to the submitted work.

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Authors and Affiliations

  1. Department of Physiology and Pharmacology, Loma Linda University, 11041 Campus Street, Loma Linda, CA, 92350, USA

    Robert P. Ostrowski & John H. Zhang

  2. Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA, 92350, USA

    John H. Zhang

  3. Department of Neurosurgery, Loma Linda University Medical Center, Loma Linda, CA, 92350, USA

    John H. Zhang

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  1. Robert P. Ostrowski
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Correspondence to John H. Zhang.

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Ostrowski, R.P., Zhang, J.H. Hyperbaric Oxygen for Cerebral Vasospasm and Brain Injury Following Subarachnoid Hemorrhage. Transl. Stroke Res. 2, 316–327 (2011). https://doi.org/10.1007/s12975-011-0069-1

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  • DOI: https://doi.org/10.1007/s12975-011-0069-1

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