Effects of hyperbaric oxygenation therapy on symptomatic pneumocephalus

Abstract

Wellingson Silva Paiva, Almir Ferreira de Andrade, Eberval Gadelha Figueiredo, Robson Luis Amorim, Marcelo Prudente, Manoel Jacobsen Teixeira Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil Background: Pneumocephalus (PNC) is defined as a pathological collection of gas within the cranial cavity. The authors studied the effects of hyperbaric oxygenation (HBO2) therapy on a group of patients with PNC, comparing them with a control group to determine the relative impact on pneumocephalus volume, clinical symptoms, and duration of hospitalization.Methods: Twenty-four patients with PNC treated at our hospital were consecutively studied. These patients were divided into a treated group (n=13) and a control group (n=11). Thirteen patients (treated group) were treated with HBO2 therapy sessions in a monoplace hyperbaric chamber at 2.5 atmospheres with 100% oxygen concentration. The control group was treated with normobaric oxygenation.Results: Clinical improvement was seen in all patients. In the treated group, a decrease of the gas bubble was observed on the computerized tomography scan after each session of HBO2. The treated group also experienced a lower rate of meningitis compared with the control group. The length of hospital stay was significantly higher in the control group compared with the treated group.Conclusions: HBO2 therapy in selective cases may lead to clinical and radiological improvement in patients with PNC.Keywords: cerebrospinal fluid leakage, head injury, meningitis