Some physicians prescribe hyperbaric oxygen therapy (HBOT) as an adjunct to approved stroke therapies in the expectation
that by increasing the circulation of oxygenated blood in the brain HBOT may help reduce the extent of
brain damage from swelling and inadequate blood supply, and possibly speed recovery and rehabilitation.
HBOT has been approved for patients with
intracranial abscess and
acute traumatic ischemias
on a similar medical basis.
But there is little clinical evidence to support this position and substantial further research is required to
determine if HBOT should be endorsed for routine treatment of stroke patients.
Hyperbaric oxygen therapy (HBOT) is not an active area of stroke research involving humans in the United States,
although a few related studies completed since 2010 have yet to publish results. In a 2014 update to a
2004 Cochrane Intervention Review, the authors concluded: “Too few patients have been studied to say whether
HBOT decreases the chance of dying, and only three trials have suggested improvement in the ability to do everyday
tasks. Overall, little evidence is currently available to support the use of HBOT for people with stroke.”
[ Cochraine, 2014 doi:10.1002/14651858.CD004954.pub3 ]
The authors of a 2014 review of HBOT treatment of acute ischemic stroke (AIS) concluded: “the safety and
effectiveness of HBO treatment on acute ischemic stroke remains to be further studied.”
[ Interventional Neurology, 2014 doi:10.1159/000362677 ]
Based on the lack of a bellweather study and the number of answers still needed to define a treatment protocol,
we rate the clinical evidence for treatment of stroke with hyperbaric oxygen therapy as Scant. In doing so we give
deference to US-based researchers, noting that clinicians in other countries are more aggressive in their use of
HBOT for stroke.