For a review of other treatment options, skip down to CONVENTIONAL TREATMENT.

For a description of the hyperbaric oxygen alternative, skip down to HYPERBARIC ALTERNATIVE.

For details of a regimen pioneered at the Center, skip down to AIR-BREAK PROTOCOL.

The failure of steroids to control or stabilize the patient is problematic because few other treatments exist. Other drugs that have been tried include nonsteroidal anti-inflammatory drugs and anticoagulation drugs. The use of these drugs is neither well studied nor widely accepted, and the results are rarely good.

If drugs fail to control the injury, surgery to remove the affected portion of the brain is the only remaining option. However, patients with multiple areas of injury, or with injury in parts of the brain that cannot be operated on, are left without any options.


In the absence of alternatives, researchers and doctors have been struggling to improve treatment for these patients. Nearly all alternative treatments that have been tried have been unsuccessful. The one exception to this is hyperbaric oxygen therapy which is already routinely used successfully for radiation injury to other parts of the body.

Image 1. Hyperbaric chamber.

Hyperbaric oxygen therapy is an accepted treatment for radiation injury to bone and soft tissue, but little research has been done to learn how it works in radiation injury to the brain. Due to the lack of research, and worries that hyperbaric treatments may have side effects worse for people with brain injuries, doctors have not yet accepted hyperbaric oxygen therapy as an alternative treatment. However, doctors and researchers at the Brain Radionecrosis Center have pioneered the use of hyperbaric oxygen therapy for brain radiation necrosis.

A treatment regimen has been developed that helps to limit the possibility of side effects. This treatment regimen is called "the accelerated air-break protocol." Using this method, the largest group of brain radionecrosis patients ever has been treated with hyperbaric oxygen therapy. The results show that the treatments are safe and effective with a high success rate.

Prior to beginning a course of hyperbaric oxygen therapy, patients are treated with an anti-seizure medicine. This is used to help minimize the possibility of seizures occurring because of the increased oxygen intake during treatment.

Treatments are given in a hyperbaric chamber, much like a diving chamber used to treat divers for "the bends." (See Image 1.) When the patient is comfortable in the chamber, it is slowly pressurized. The rate of increasing pressure is adjusted so the patient feels no discomfort, although sometimes the patient's ears will "pop" like when landing in an airplane. The final pressure in the chamber is like being about 60 feet under water. This pressure is maintained while the patient breathes 100% oxygen with short breaks for breathing normal air. At the end of the treatment, the pressure in the chamber is slowly released.

Patients continue daily treatments, five days a week. Patients undergo complete examinations by a doctor weekly and have brain scans after every 20 treatments (approximately once a month). Patients are usually treated for about 3 months. Patients are examined again several months after stopping treatment to make sure that the brain radionecrosis injury has been successfully treated.

For the mechanism of action of hyperbaric oxygen therapy, jump to the HOW IT WORKS page.

For results among patients treated with hyperbaric oxygen therapy, jump to the OUTCOMES page.

For ongoing studies of hyperbaric oxygen therapy, jump to the RESEARCH page.