Ph.D Thesis

Ph.D StudentPalzur Eilam
SubjectEffect of Hyperbaric Oxygen Treatment on Avenues of
Secondary Brain Injury
DepartmentDepartment of Medicine
Supervisors PROF. Jean Francois Soustiel
PROF. Ran Arieli
Full Thesis text - in Hebrew Full thesis text - Hebrew Version


Traumatic brain injuries (TBI) constitute a major health and socio-economic challenge in developed countries, representing the leading cause of death and disability among young adults. This formidable challenge has triggered an intense effort for the development of new therapeutic horizons, so far without success. Among the reasons often advocated for the failure of neuroprotective agents is the fact that they were over-targeted, neglecting apoptosis on one hand and, on the other hand, have focused of neuron survival without paying much attention to glial cells.

Traumatic brain injury can be divided into primary injury, the immediate and nonreversible mechanical damage that occurs at the moment of impact; and secondary injury, characterized by delayed death of damaged but yet viable brain tissue. This secondary injury is a complex network of interacting structural, functional, cellular, and molecular changes. Among these alterations are the breakdown of the blood-brain barrier, edema formation, and impairment of energy metabolism, changes in cerebral perfusion, ionic dyshomeostasis, activation of autodestructive neurochemicals and enzymes, generation of free radicals, and genomic expressions. Alone or in combination these events may lead to delayed cell death, but, because many are potentially reversible, a chance exists for curative intervention to attenuate cellular damage and improve outcome. In this regard, increasing attention has been recently drawn to beneficial effect of hyperbaric oxygen therapy (HBOT) for the reduction of delayed neuronal death. However, conflicting results have been documented following the use of hyperbaric oxygen. In spite of few, supportive laboratory and clinical evidence as remain sporadic and ambiguous. In the present study, we attempted to evaluate the potential value of HBOT as a treatment for reduction of secondary traumatic brain damage in a rat model of focal cerebral contusion.