Figure 1.
Flowchart of the patients in the study.
Table 1.
Baseline patients' characteristics.
Figure 2.
The results of the neurological evaluation. Each point represents a patient.
(A–C) NIHSS score: (A) Scores of the treated group patients before and after the HBOT period (B) Scores of the cross group before and after the control (no treatment) period. (C) Scores of the cross group after the HBOT period. (D–F) The same as (A)-(C) for the activities of daily living (ADL) scores. We note that the lines indicate the diagonal. Abbreviation: NIHSS = National Institutes of Health Stroke Scale; ADL = Activities of Daily Living.
Table 2.
Summary of the results of the National Institutes of Health Stroke Scale (NIHSS), activities of daily living (ADL) and quality of life questionnaire (EQ-5D and EQ-VAS).
Figure 3.
Scatter plot analysis of the changes in the combined neurological evaluations.
The scatter plot shows changes in the NIHSS and ADL scores in terms of the scaled relative differences as is defined in the methods section (averaged difference (<SFj–SIj>) is not divided by STD(SFj−SIj)). The color code is – changes during the treatment periods for the HBOT treated group (red diamonds), changes during for the HBOT-treated cross group (red circles) and changes during the control (non-treatment) period of the HBOT-treated cross group (blue circles).
Figure 4.
Volume rendered Brain SPECT perfusion maps of Example 1.
The results are of a patient in the cross group, suffering from left hemiparesis due to ischemic stroke that occurred 1 year prior to inclusion in the study. Baseline and control volume rendered brain perfusion views show diffuse hypoperfusion in the right hemisphere involving the fronto-parietal region and right postero-medial frontal (right motor cortex), right medial parietal and posterior-parietal (sensory cortex and associative motor cortex) (red circles). The HBOT SPECT scan done at the end of HBOT treatments shows disappearance of the perfusion deficits that were still demonstrated at the end of the control period. In addition, a significant global cortical and subcortical (basal ganglia and thalamic nuclei) perfusion improvement is seen.
Figure 5.
Volume rendered Brain SPECT perfusion maps of Example 2.
The results are of a patient in the treated group, suffering from right hemiparesis due to ischemic stroke that occurred 14 months prior to her inclusion in the study. Comparison of pre- and post-hyperbaric treatment SPECT scans. These SPECT images demonstrate significant improvement of perfusion deficits in the left hemisphere involving the medial and posterolateral frontal area (motor cortex, red circles) and lateral inferior frontal region (Broca's area, blue circles) in comparison to the baseline SPECT. HBOT SPECT findings correlate positively with the patient's improved motor and verbal functions.
Figure 6.
Volume rendered Brain SPECT perfusion maps of Example 3.
The results are of a patient in the treated group suffering from left hemiparesis due to ischemic stroke that occurred 26 months prior to inclusion in the study. The brain perfusion maps (upper two images) show the infracted brain (deep blue color) involving the right antero-postero-lateral frontal, right superior-parietal and right parieto-occipital regions. Curved sagittal view in CT MIP reconstruction of the brain shows the anatomical stroke area (left lower image, V = posterior horn of right ventricle). The peri-infarct region show improved perfusion as demonstrated by HBOT image (right upper image). Quantitation of the cerebral blood flow (CBF) change (delta between baseline and HBOT) is demonstrated in the right lower image.