Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2014 Nov 12;2014(11):CD004954.
doi: 10.1002/14651858.CD004954.pub3.

Hyperbaric oxygen therapy for acute ischaemic stroke

Michael H Bennett, Stephanie Weibel, Jason Wasiak, Alexander Schnabel, Christopher French, Peter Kranke
Meta-Analysis

Hyperbaric oxygen therapy for acute ischaemic stroke

Michael H Bennett et al. Cochrane Database Syst Rev. .

Abstract

Background Most cases of stroke are caused by impairment of blood flow to the brain (ischaemia), which results in a reduction in available oxygen and subsequent cell death. It has been postulated that hyperbaric oxygen therapy (HBOT) may reduce the volume of brain that will die by greatly increasing available oxygen, and it may further improve outcomes by reducing brain swelling. Some centres are using HBOT routinely to treat people with stroke. This is an update of a Cochrane Review first published in 2005.Objectives To assess the effectiveness and safety of adjunctive HBOT in the treatment of people with acute ischaemic stroke.Search methods We searched the Cochrane Stroke Group Trials Register (last searched April 2014), the Cochrane Central Register of Controlled Trials(CENTRAL) (April 2014), MEDLINE (1966 to April 2014), EMBASE (1980 to April 2014), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to April 2014), the Database of Randomised Controlled Trials in Hyperbaric Medicine(DORCTIHM) (searched April 2014) and the reference lists of articles.We handsearched relevant publications and contacted researchers to identify additional published and unpublished studies.Selection criteria Randomised controlled trials (RCTs) that compared the effects of adjunctive HBOT versus those of no HBOT (no treatment or sham).Data collection and analysis Three review authors independently extracted data, assessed each trial for internal validity and resolved differences by discussion.Main results We included 11 RCTs involving 705 participants. The methodological quality of the trials varied. We could pool data only for case fatalities. No significant differences were noted in the case fatality rate at six months in those receiving HBOT compared with the control group (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.34 to 2.75, P value 0.96). Four of 14 scale measures of disability and functional performance indicated improvement following HBOT, for example, the mean Trouillas Disability Scale score was lower with HBOT (mean difference (MD) 2.2 point reduction with HBOT, 95% CI 0.15 to 4.3, P value 0.04), and the mean Orgogozo Scale score was higher (MD 27.9 points, 95% CI 4.0 to 51.8, P value 0.02).Authors' conclusions We found no good evidence to show that HBOT improves clinical outcomes when applied during acute presentation of ischaemic stroke. Although evidence from the 11 RCTs is insufficient to provide clear guidelines for practice, the possibility of clinical benefit has not been excluded. Further research is required to better define the role of HBOT in this condition.

PubMed Disclaimer

Conflict of interest statement

None known. Dr Bennett is a hyperbaric physician who does not routinely treat people with stroke.

Figures

1
1
Study flow diagram.
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
1.1
1.1. Analysis
Comparison 1 Mortality, Outcome 1 Death at 3 to 6 months.
2.1
2.1. Analysis
Comparison 2 Severe functional disability, Outcome 1 No effect of therapy—participants unable to care for themselves.
3.1
3.1. Analysis
Comparison 3 Functional scales, Outcome 1 Mean neurological score at day 5.
3.2
3.2. Analysis
Comparison 3 Functional scales, Outcome 2 Mean neurological score at week 6.
3.3
3.3. Analysis
Comparison 3 Functional scales, Outcome 3 Mean neurological score at 1 year.
3.4
3.4. Analysis
Comparison 3 Functional scales, Outcome 4 Mean Orgogozo score at 6 months.
3.5
3.5. Analysis
Comparison 3 Functional scales, Outcome 5 Mean Orgogozo score at 1 year.
3.6
3.6. Analysis
Comparison 3 Functional scales, Outcome 6 Mean Trouillas score at 6 months.
3.7
3.7. Analysis
Comparison 3 Functional scales, Outcome 7 Mean Trouillas score at 1 year.
3.8
3.8. Analysis
Comparison 3 Functional scales, Outcome 8 Mean Rankin score at 6 months.
3.9
3.9. Analysis
Comparison 3 Functional scales, Outcome 9 Mean Rankin score at 1 year.
3.10
3.10. Analysis
Comparison 3 Functional scales, Outcome 10 Mean neurological recovery score at 12 months.
3.11
3.11. Analysis
Comparison 3 Functional scales, Outcome 11 Neurological function deficit score at 3 weeks.
4.1
4.1. Analysis
Comparison 4 Deemed to have a good outcome, Outcome 1 NIHSS 0 or improved by 4 points at 24 hours.
4.2
4.2. Analysis
Comparison 4 Deemed to have a good outcome, Outcome 2 Modified Rankin score less than 2 at 90 days.
4.3
4.3. Analysis
Comparison 4 Deemed to have a good outcome, Outcome 3 Glasgow Outcome Score of 5.
4.4
4.4. Analysis
Comparison 4 Deemed to have a good outcome, Outcome 4 NIHSS less than 2.
4.5
4.5. Analysis
Comparison 4 Deemed to have a good outcome, Outcome 5 Deemed cured and self‐caring.
5.1
5.1. Analysis
Comparison 5 Activities of daily living, Outcome 1 Barthel Index 95 or 100 at 90 days.
5.2
5.2. Analysis
Comparison 5 Activities of daily living, Outcome 2 Mean Barthel Index at 3 weeks.
6.1
6.1. Analysis
Comparison 6 Mean volume of infarct on CT, Outcome 1 Mean volume of infarct at 4 months.
7.1
7.1. Analysis
Comparison 7 Adverse effects of therapy, Outcome 1 Ear pain.
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

References to studies included in this review

Anderson 1991 {published data only}
    1. Anderson DC, Bottini AG, Jagiella WM, Westphal B, Ford S, Rockswold GL, et al. A pilot study of hyperbaric oxygen in the treatment of human stroke. Stroke 1991;22(9):1137‐42. [199100] - PubMed
Hong 2008 {published data only}
    1. Hong L, Yu S. Efficacy of hyperbaric oxygen in treatment of ischemic stroke among young patients. Journal of Rehabilitation Medicine 2008;Suppl 46:110.
Imai 2006 {published data only}
    1. Imai K, Mori T, Izumoto H, Takabatake N, Kunieda T, Watanabe M. Hyperbaric oxygen combined with intravenous edaravone for treatment of acute embolic stroke: a pilot clinical trial. Neurologia Medico‐Chirurgica 2006;46(8):373‐8. - PubMed
Li 1998 {published data only}
    1. Li F, Chen L, Gu D. Effect of hyperbaric oxygenation on cerebral blood flow and EEG in cerebral infarction. Chinese Journal of Physical Therapy 1998;21(2):72‐4.
Nighoghossian 1995 {published data only}
    1. Nighoghossian N, Trouillas M, Adeleine P, Salord F. Hyperbaric oxygen in the treatment of acute ischaemic stroke. A double‐blind pilot study. Stroke 1995;26:1369‐72. - PubMed
Peng 2003 {published data only}
    1. Peng ZR, Zhu SL, Xiao PT. Changes and efficacy evaluation of serum nitrogen monoxide and oxygen‐derived free radicals in patients with cerebral infarction before and after hyperbaric oxygen therapy. Chinese Journal of Clinical Rehabilitation 2003;7(16):2318‐9.
Rusyniak 2003 {published data only}
    1. Rusyniak DE, Kirk MA, May JD, Kao LW, Brizendine EJ, Welch JL, et al. Hyperbaric oxygen therapy in acute ischemic stroke: results of the Hyperbaric Oxygen in Acute Ischemic Stroke Trial Pilot Study. Stroke 2003;34(2):571‐4. [12574578] - PubMed
Sansone 1997 {published data only}
    1. Sansone A, Gulotta G, Sparacia B, Alongi A, Savola G, Sparacia GV. Effect of hyperbaric oxygen therapy on neurologic recovery after focal cerebral ischaemia. British Journal of Anaesthesia 1997;78 Suppl 1:73‐4.
Yang 2003 {published data only}
    1. Yang X, Li K, He T. The effect of early hyperbaric oxygenation on the ability of daily life of patients with stroke. Chinese Journal of Clinical Rehabilitation 2003;7(7):1221.
Yang 2004 {published data only}
    1. Yang Z, Chen H, Xian M‐J, Jiang X‐D, Yuan Li, Mai J‐H. Role of medical pressured oxygen injector in the rehabilitation of motor function and abilities of daily living at early stage of cerebral infarction. Chinese Journal of Clinical Rehabilitation 2004;8(13):2414‐5.
Zhao 2008 {published data only}
    1. Zhao R, Wang C, Wang Y. Changes in serum cellular adhesion molecule and matrix metalloproteinase‐9 levels in patients with cerebral infarction following hyperbaric oxygen therapy. A case and intergroup control study. Neural Regeneration Research 2008;3(11):1245‐8.

References to studies excluded from this review

Belokurov 1988 {published data only}
    1. Belokurov YuM, Golland AV, Kochetov KhA. Hyperbaric oxygenation in hypoxic brain injuries. Khirurgiya 1988;64(8):12‐7. [198800] - PubMed
Boschetty 1970 {published data only}
    1. Boschetty V, Dostal J, Holek J. Use of hyperbaric oxygenation in acute cerebrovascular accidents. (Preliminary report). Bratislavske Lekarske Listy 1970;53(2):160‐4. [5432216] - PubMed
Chen 2007 {published data only}
    1. Chen L, Li F, Gu D. Hyperbaric oxygen for cerebral blood flow and electroencephalogram in patients with acute cerebral infarction. Neural Regeneration Research 2007;2(3):171‐4.
Chen 2012 {published data only}
    1. Chen C‐H, Chen S‐Y, Wang V, Chen C‐C, Wang K‐C, Chen C‐H, et al. Effects of repetitive hyperbaric oxygen treatment in patients with acute cerebral infarction: a pilot study. Scientific World Journal 2012;2012:Article ID 694703. - PMC - PubMed
Chen 2013 {published data only}
    1. Chen F‐P, Yu X‐X. Short‐term effect of hyperbaric oxygen combined with edaravone and ozagrel sodium in treating progressive cerebral infarction. Chinese Journal of Evidence‐Based Medicine 2013;13(4):413‐6.
Dong 2005 {published data only}
    1. Dong X‐L, Niu S‐Y, Xu H‐B, Han M‐Y. Effects of hyperbaric oxygenation associated with panax notoginseng saponins therapy on hemorrhology indexes in patients with ischemic cerebrovascular disease. Chinese Journal of Clinical Rehabilitation 2005;9(41):6‐7.
Efrati 2013 {published data only}
    1. Efrati S, Fishlev G, Bechor Y, Volkov O, Bergan J, Kliakhandler K, et al. Hyperbaric oxygen induces late neuroplasticity in post stroke patients—randomized, prospective trial. PLoS One 2013;8(1):e53716. - PMC - PubMed
Efuni 1987 {published data only}
    1. Efuni SN, Lebedeva RN, Shikunova LG, Demurov EA, Mutuskina EA. Hyperbaric oxygenation in the therapy of hypoxic brain damage. Patologicheskaia Fiziologiia i Eksperimental'naia Terapiia 1987;3:24‐7. [3627829] - PubMed
Elinsky 1984 {published data only}
    1. Elinsky MP, Rafikov AM, Ivanova NE, Kesaev SA. Therapeutic application of hyperbaric oxygenation in ischemic strokes. Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova 1984;84(9):1321‐5. - PubMed
Gusev 1990 {published data only}
    1. Gusev EI, Kazantseva NV, Nifontova LA, Petukhov EB, Makarova LD, Zhuravlev AK, et al. On the mechanism of the therapeutic effect of hyperbaric oxygenation at minor differential pressure in patients with brain stroke. Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova 1990;90(1):34‐40. [199000] - PubMed
Heyman 1966 {published data only}
    1. Heyman A, Saltzman HA, Whalen RE. The use of hyperbaric oxygenation in the treatment of cerebral ischemia and infarction. Circulation 1966;33(5 Suppl):II20‐7. [5006557] - PubMed
Holbach 1979 {published data only}
    1. Holbach KH, Wassmann H. Advantage of using hyperbaric oxygenation (HO) in combination with extra‐cranial arterial bypass (EIAB) in the treatment of completed stroke. Acta Neurochirurgica 1979;28 Suppl:309. - PubMed
Kaasik 1988 {published data only}
    1. Kaasik A‐EA, Dmitriev KK, Tomberg TA. Hyperbaric oxygenation in the treatment of patients with ischemic stroke. Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova 1988;88(9):34‐42. [198800] - PubMed
Kazantseva 2005 {published data only}
    1. Kazantseva N, Volkova NA, Petukcov EB. Effect of normoxic curative compression on microcirculation in acute stroke. Journal of the Neurological Sciences 2005;238:S407.
Kazantseva 2006 {published data only}
    1. Kazantseva NV. Study of the effectiveness of two curative regimens of hyperbaric therapy in acute stroke. International Journal of Stroke 2006;1 Suppl 1:73.
Lebedev 1983 {published data only}
    1. Lebedev VV, Isakov IuV, Pravdenkova SV. Effect of hyperbaric oxygenation on the clinical course and complications of the acute period of ischemic strokes. Zhurnal Voprosy Neirokhirurgii Imeni N. N. Burdenko 1983;3:37‐42. [6613431] - PubMed
Oshima 1990 {published data only}
    1. Oshima M, Sadoshima S, Kusuda K, Yao H, Yagi H, Fujishima M. Clinical application of hyperbaric oxygen therapy for acute cerebral infarction. Undersea Biomedical Research Supplement 1990;17:140.
Pan 1996 {published data only}
    1. Pan H. Clinical study of hyperbaric oxygen plus fonzylane on cerebral infarction. Chinese Journal of Nervous and Mental Diseases 1996;22(4):217.
Pravdenkova 1983 {published data only}
    1. Pravdenkova SV, Isakov IuV, Ioffe IuS. Therapeutic effect of hyperbaric oxygenation in the acute stage of an ischemic stroke. Anesteziologiia i Reanimatologiia 1983;6:26‐30. [6670766] - PubMed
Pravdenkova 1984 {published data only}
    1. Pravdenkova SV, Romasenko MV, Shelkovskii VN. Hyperbaric oxygenation and prevention of recurrent cerebral circulatory disorders in the acute stage of a stroke. Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova 1984;84(8):1147‐51. [6495936] - PubMed
Sarno 1972a {published data only}
    1. Sarno JE, Rusk HA, Diller L, Sarno MT. The effect of hyperbaric oxygen on the mental and verbal ability of stroke patients. Stroke 1972;3(1):10‐5. [5008300] - PubMed
Sarno 1972b {published data only}
    1. Sarno MT, Sarno JE, Diller L. The effect of hyperbaric oxygen on communication function in adults with aphasia secondary to stroke. Journal of Speech and Hearing Research 1972;15(1):42‐8. [5012810] - PubMed
Soodan 1992 {published data only}
    1. Soodan KS, Roy AK, Singh PK, Sing S, Hegde KP. Hyperbaric oxygen therapy in stroke cases. Indian Journal of Aerospace Medicine 1992;36(1):28‐31.
Vila 2005 {published data only}
    1. Vila JF, Balcarce PE, Abiusi GR, Dominguez RO, Pisarello JB. Improvement in motor and cognitive impairment after hyperbaric oxygen therapy in a selected group of patients with cerebrovascular disease: a prospective single‐blind controlled trial. Undersea and Hyperbaric Medicine 2005;32(5):341‐9. - PubMed
Xia 1995 {published data only}
    1. Xia XG, Huang ZM, Zhou X. The effect of rotation magnetic field and hyperbaric oxygen on free radical metabolism in cerebral apoplexy. Chinese Journal of Physical Therapy 1995;18(3):140‐2.
Xing 2007 {published data only}
    1. Xing J, Wang Y, Li Y. Clinical study on acupuncture combined with hyperbaric oxygenation for improving balance function of cerebral infarction. Chinese Acupuncture and Moxibustion 2007;27(1):12‐4. - PubMed
Yang 2002 {published data only}
    1. Yang S, Li B, Liu S. The therapeutic effect of the hyperbaric oxygen on diabetic cerebral haemorrhage in the aged. Guangxi Medical Journal 2002;24(3):303‐4.
Zhang 2000 {published data only}
    1. Zhang H, Gao P, Jia Z. The evaluation of hyperbaric oxygen therapy on neuropsychological impairments in senile cerebral infarction patients. Chinese Mental Health Journal 2000;14(3):209‐10.

References to ongoing studies

Michalski 2008 {published data only}
    1. Michalski D, Kueppers‐Tiedt L, Hobohm C, Schulz A, Wagner A, Schneider D. Combination of systemic intravenous thrombolysis and hyperbaric oxygen therapy (HBOT) in acute ischemic stroke, a randomized single‐blinded trial has started. International Journal of Stroke 2008;3 Suppl 1:459.

Additional references

Al‐Waili 2005
    1. Al‐Waili NS, Butler GJ, Beale J, Abdullah MS, Hamilton WB, Lee BY, et al. Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease. Adavances in Therapy 2005;22(6):659‐78. - PubMed
Badr 2001
    1. Badr AE, Yin W, Mychaskiw G, Zhang JH. Effect of hyperbaric oxygen on striatal metabolites: a microdialysis study in awake freely moving rats after MCA occlusion. Brain Research 2001;916(1‐2):85‐90. [11597594] - PubMed
Bamford 1991
    1. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet 1991;337:1521‐6. [MEDLINE: ] - PubMed
Bath 2000
    1. Bath PM, Lees KR. ABC of arterial and venous disease. Acute stroke. BMJ 2000;320:920‐3. [MEDLINE: ] - PMC - PubMed
Bennett 2004
    1. Bennett MH, Connor D. The Database of Randomised Controlled Trials in Hyperbaric Medicine (DORCTIHM). www.hboevidence.com (accessed 14 September 2008).
Carson 2005
    1. Carson S, McDonagh M, Russman B, Helfand M. Hyperbaric oxygen therapy for stroke: a systematic review of the evidence. Clinical Rehabilitation 2005;19:819‐833. - PubMed
CASTCG 1997
    1. Chinese Acute Stroke Trial Collaborative Group. CAST: randomised placebo‐controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. Lancet 1997;349:1641‐9. [MEDLINE: ] - PubMed
Clark 1982
    1. Clark JM. Oxygen toxicity. In: Bennett PB, Elliott DH editor(s). The Physiology and Medicine of Diving. 3rd Edition. London: Bailliere, Tindall and Cox, 1982:200‐38.
D'Olhaberriague 1996
    1. D'Olhaberriague L, Mitsias P. A reappraisal of reliability and validity studies in stroke. Stroke 1998;27:2331‐6. - PubMed
DerSimonian 1986
    1. DerSimonian R, Laird N. Meta‐analysis in clinical trials. Controlled Clinical Trials 1986;7(3):177‐88. - PubMed
Hart 1971
    1. Hart GB, Thompson RE. The treatment of cerebral ischemia with hyperbaric oxygen (OHP). Stroke 1971;2(3):247‐50. [MEDLINE: ] - PubMed
Higgins 2011
    1. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane‐handbook.org.
Hills 1999
    1. Hills BA. A role for oxygen‐induced osmosis in hyperbaric oxygen therapy. Medical Hypotheses 1999;52(3):259‐63. [MEDLINE: ] - PubMed
Ikeda 1990
    1. Ikeda Y, Long DM. The molecular basis of brain injury and brain edema: the role of oxygen free radicals. Neurosurgery 1990;27:1‐11. [MEDLINE: ] - PubMed
Ingvar 1965
    1. Ingvar DH, Lassen NA. Treatment of focal cerebral ischaemia with hyperbaric oxygen. Report of 4 cases. Acta Neurologica Scandinavica 1965;41:92‐5. [MEDLINE: ] - PubMed
ISTCG 1997
    1. The International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke. Lancet 1997;349:1569‐81. [MEDLINE: ] - PubMed
Jain 1999
    1. Jain KK. In: Jain KK editor(s). Textbook of Hyperbaric Medicine. 3rd Edition. Seattle: Hogrefe and Huber, 1999. [MEDLINE: ]
Jain 2009
    1. Jain KK. Textbook of hyperbaric medicine. Textbook of Hyperbaric Medicine. 5th Edition. Seattle: Hogrefe and Huber, 2009. [ISBN: 978‐0‐88937‐361‐7]
Khan 2003
    1. Khan B, Evans AW, Easterbrook M. Refractive changes in patients undergoing hyperbaric oxygen therapy: a prospective study. Undersea and Hyperbaric Medicine 2003;24 Suppl:9.
Kindwall 1999
    1. Kindwall EP, Whelan HT. In: Kindwall EP, Whelan HT editor(s). Hyperbaric Medicine Practice. 2nd Edition. Flagstaff: Best Publishing Company, 1999. [MEDLINE: ]
Mathieu 2006
    1. Mathieu 2006. Handbook on Hyperbaric Medicine. 1st Edition. Dordrecht: Springer, 2006.
Mink 1995a
    1. Mink RB, Dutka AJ. Hyperbaric oxygen after global cerebral ischemia in rabbits does not promote brain lipid peroxidation. Critical Care Medicine 1995;23(8):1398‐404. [MEDLINE: ] - PubMed
Mink 1995b
    1. Mink RB, Dutka AJ. Hyperbaric oxygen after global cerebral ischemia in rabbits reduces brain vascular permeability and blood flow. Stroke 1995;26(12):2307‐12. [MEDLINE: ] - PubMed
Murray 1997
    1. Murray CJ, Lopez AD. Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 1997;349:1269‐76. [MEDLINE: ] - PubMed
Neubauer 1980
    1. Neubauer RA, End E. Hyperbaric oxygenation as an adjunct therapy in strokes due to thrombosis. A review of 122 patients. Stroke 1980;11(3):297‐300. [MEDLINE: ] - PubMed
Nighoghossian 1997
    1. Nighoghossian N, Trouillas P. Hyperbaric oxygen in the treatment of acute ischemic stroke: an unsettled issue. Journal of Neurological Sciences 1997;150(1):27‐31. [MEDLINE: ] - PubMed
Orgogozo 1998
    1. Orgogozo J‐M. Advantages and disadvantages of neurological scales. Cerebrovascular Diseases 1998;8 Suppl 2:2‐7. - PubMed
Oriani 1996
    1. Oriani G, Marroni A, Wattel F. In: Oriani G, Marroni A, Wattel F editor(s). Handbook on Hyperbaric Medicine. 1st Edition. Milan: Springer, 1996. [MEDLINE: ]
Robertson 1989
    1. Robertson CS, Narayan RK, Gokaslan ZL, Pahwa R, Grossman RG, Caram P Jr, et al. Cerebral arteriovenous oxygen difference as an estimate of cerebral blood flow in comatose patients. Journal of Neurosurgery 1989;70:222‐30. [MEDLINE: ] - PubMed
Selman 2004
    1. Selman WR, Lust WD, Pundik S, Zhou Y, Ratcheson RA. Compromised metabolic recovery following spontaneous spreading depression in the penumbra. Brain Research 2004;999(2):167‐74. [14759495] - PubMed
Siesjo 1989
    1. Siesjo BK, Agardh CD, Bengtsson F. Free radicals and brain damage. Cerebrovascular and Brain Metabolism Review 1989;1:165‐211. [MEDLINE: ] - PubMed
Sudlow 1997
    1. Sudlow CL, Warlow CP. Comparable studies of the incidence of stroke and its pathological types: results from an international collaboration. International Stroke Incidence Collaboration. Stroke 1997;28(3):491‐9. [MEDLINE: ] - PubMed
Sukoff 1982
    1. Sukoff MH, Ragatz RE. Hyperbaric oxygenation for the treatment of acute cerebral edema. Neurosurgery 1982;10(1):29‐38. [MEDLINE: ] - PubMed
SUTC 2004
    1. Stroke Unit Trialists' Collaboration. Organised inpatient (stroke unit) care for stroke. Cochrane Database of Systematic Reviews 2004, Issue 1. [DOI: 10.1002/14651858.CD000197.pub2] - DOI - PubMed
Thom 1993
    1. Thom SR. Functional inhibition of leukocyte B2 integrins by hyperbaric oxygen in carbon monoxide‐mediated brain injury in rats. Toxicology and Applied Pharmacology 1993;123(2):248‐56. [MEDLINE: ] - PubMed
Van Gijn 1992
    1. Gijn J. Measurement of outcome in stroke prevention trials. Cerebrovascular Disease 1992;2 Suppl 2:23‐34.
Wardlaw 2004
    1. Wardlaw JM, Keir SL, Seymour J, Lewis S, Sandercock PA, Dennis MS, et al. What is the best imaging strategy for acute stroke?. Health Technology Assessment 2004;8(1):1‐180. [MEDLINE: ] - PubMed
Yusa 1987
    1. Yusa T, Beckman JS, Crapo JD, Freeman BA. Hyperoxia increases H2O2 production by brain in vivo. Journal of Applied Physiology 1987;63:353‐8. - PubMed

References to other published versions of this review

Bennett 2005
    1. Bennett MH, Wasiak J, Schnabel A, Kranke P, French C. Hyperbaric oxygen therapy for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2005, Issue 3. [DOI: 10.1002/14651858.CD004954.pub2] - DOI - PubMed

LinkOut - more resources