Background: The use of hyperbaric oxygen therapy in cases with traumatic brain injury is based on the hypothesis that injured or inactive neurons would greatly benefited from increased blood flow and oxygen delivery, which later could act to metabolically or electrically may reactivate the cells. Objective: To evaluate the optimal number of hyperbaric oxygen therapy sessions required in patients with head injury and to compare the neurological effects of 10, 20 and 30 sessions of hyperbaric oxygen therapy in patients with traumatic brain injury. Study Design: Prospective randomized clinical trial. Place of Study: The study was carried out at the Prana HBO Centre, which is owned by the Investigator and located in the Northern parts of Mumbai, in India. Methods: Study was conducted over a period of 3 years and patient with Head injury referred to the Hyperbaric Unit at Prana HBO center after the initial evaluation and surgical procedure were included. Patients were randomly assigned to any of the three groups and allotted numbers were concealed to receive HBO therapy. HBO therapy was given with compressed with air at a pressure of 1.8 atmosphere absolute (ata). At this pressure the patient breathed 100% oxygen via facial mask. The HBO therapy protocol included 90 minutes oxygen breathing at 1.8 ata, 6 days a week. Results and Discussion: A significant improvement in GCS scores in group H10 between the end of 10 HBOT sittings and at the end of 30th day. As well significant improvement in scores of group H20 between the end of 20 sittings and at 30th day was being observed. GOS was seen better after 20 and 30 sessions of hyperbaric oxygen therapy as compared to group I of HBOT group III showed maximum improvement in spasticity in comparisons to group I and II, however there was good improvement in spasticity all the three group. Mood swings was less in group III with only 12% patients showing mood swings, whereas in group II and group I it was around 59% and 93% respectively. Fasano carried out first clinical observation and presented a therapeutic effect of hyperbaric oxygen therapy in traumatic brain injury patients and concluded that the HBO improved the outcome following brain trauma. Conclusion: Our findings shows the beneficial effects of HBO therapy in traumatic brain injury patients on GCS score, GOS, spasticity and mood swings with increase in number of multiple sessions. Despite these encouraging results further research is needed to more clearly define the mechanism and potential role of HBOT following traumatic brain injury.

Keywords: HBOT; Traumatic brain injury; Clinical Trial.