PDF(Pubmed)
Abstract：
BACKGROUND: Whether hyperbaric oxygen therapy (HBOT) can cause paradoxical herniation is still unclear.
METHODS: A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery. HBOT was administered 22 d after surgery due to speech impairment. Paradoxical herniation appeared on the second day after treatment, and the patient\'s condition worsened after receiving mannitol treatment at the rehabilitation hospital. After timely skull repair, the paradoxical herniation was resolved, and the patient regained consciousness and had a good recovery as observed at the follow-up visit.
CONCLUSIONS: Paradoxical herniation is rare and may be caused by HBOT. However, the underlying mechanism is unknown, and the understanding of this phenomenon is insufficient. The use of mannitol may worsen this condition. Timely skull repair can treat paradoxical herniation and prevent serious complications.
METHODS: A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery. HBOT was administered 22 d after surgery due to speech impairment. Paradoxical herniation appeared on the second day after treatment, and the patient\'s condition worsened after receiving mannitol treatment at the rehabilitation hospital. After timely skull repair, the paradoxical herniation was resolved, and the patient regained consciousness and had a good recovery as observed at the follow-up visit.
CONCLUSIONS: Paradoxical herniation is rare and may be caused by HBOT. However, the underlying mechanism is unknown, and the understanding of this phenomenon is insufficient. The use of mannitol may worsen this condition. Timely skull repair can treat paradoxical herniation and prevent serious complications.
摘要：
背景：高压氧治疗（HBOT）是否会引起矛盾的疝仍不清楚。
方法：一名因脑外伤而昏迷的65岁患者行开颅减压术，术后逐渐恢复意识。术后22d因言语障碍给予HBOT。矛盾的疝出现在治疗后的第二天，在康复医院接受甘露醇治疗后，患者的病情恶化。经过及时的颅骨修复,矛盾的疝被解决了,患者恢复了意识，并在随访中观察到恢复良好。
结论：矛盾的疝是罕见的，可能是由HBOT引起的。然而,潜在的机制是未知的，对这种现象的认识不足。使用甘露醇可能会使这种情况恶化。及时进行颅骨修补术可以治疗矛盾的疝，并防止严重的并发症。
方法：一名因脑外伤而昏迷的65岁患者行开颅减压术，术后逐渐恢复意识。术后22d因言语障碍给予HBOT。矛盾的疝出现在治疗后的第二天，在康复医院接受甘露醇治疗后，患者的病情恶化。经过及时的颅骨修复,矛盾的疝被解决了,患者恢复了意识，并在随访中观察到恢复良好。
结论：矛盾的疝是罕见的，可能是由HBOT引起的。然而,潜在的机制是未知的，对这种现象的认识不足。使用甘露醇可能会使这种情况恶化。及时进行颅骨修补术可以治疗矛盾的疝，并防止严重的并发症。
