Stroke remains a leading cause of long-term disability, with limited recovery potential during the chronic phase. Hyperbaric oxygen therapy has shown promise in promoting neuroplasticity and functional recovery through mechanisms such as the hyperoxic-hypoxic paradox. We report the case of a 45-year-old Arabic male who experienced a left-sided hemorrhagic stroke and presented with persistent neurological deficits 15 months post-event. He exhibited right hemiparesis, impaired gait requiring a wheelchair, and cognitive dysfunction. The patient underwent 83 sessions of hyperbaric oxygen therapy over 16 weeks (2.0 ATA, 90 minutes with air breaks). Pre- and postintervention assessments included neurological and cognitive evaluations alongside advanced imaging: diffusion tensor imaging and Single photon emission computed tomography. Clinically, the patient showed marked improvements in muscle strength, spasticity, balance, and walking—progressing from wheelchair dependence to ambulation with a quadruped cane. Cognitive testing demonstrated improved attention, verbal memory, and processing speed. Imaging findings supported these changes: diffusion tensor imaging showed increased fractional anisotropy in major white matter tracts, and single photon emission computed tomography demonstrated significant perfusion increases in the right motor cortex (+ 15.83%) and right frontal lobe (+ 15.92%). This case highlights hyperbaric oxygen therapy's potential to facilitate recovery in chronic post-stroke stages by enhancing neuroplasticity and neurovascular function in nonnecrotic brain regions. Advanced imaging techniques, such as diffusion tensor imaging and single photon emission computed tomography, provide valuable insights into treatment efficacy and may support personalized therapeutic protocols in the future.
Khairy et al. (Thu,) studied this question.