The effectiveness of hyperbaric oxygen modalities against vascular component of traumatic brain injury

Intracranial bleeding occurs in a substantial percentage of patients with neurotrauma and may gravely impact clinical outcomes. Hyperbaric oxygen (HBO) has been tested for traumatic brain injury (TBI), however its effect on the hemorrhagic component of TBI remains poorly understood. The characteristics of intracranial bleeding vary in different animal models of TBI. HBO appears to combat vascular injury and to reduce hemorrhagic complications. While the number of studies is limited, a decrease in intracranial bleeding and protection from BBB destruction may determine the effectiveness of HBO in TBI. Based on the results of experimental and clinical studies, this review advocates that intracranial bleeding in the course of TBI is the indispensable aspect of outcome assessment and postulate the search for new markers of traumatic vascular injury responsive to oxygen treatment.