In children the brain is still developing and therefore the
prospects for improvement are very much greater than in adults.
Loss of function in the brain can be either due to tissue swelling,
which is reversible, or tissue destruction, which is not. The
recoverable areas can now be identified by a technique called SPECT
imaging. The initials stand for Single Photon Emission Computed
Tomography. It can demonstrate blood flow, which is linked to
metabolism of the brain which is, of course, directly related to
oxygen availability. By giving oxygen at the high dosages possible
under hyperbaric conditions, areas which are not ''dead but sleeping''
can be identified. This phenomenon has been discussed for many years
in stroke patients and authorities have even stated that the critical
parameter is not blood flow it is oxygen delivery. Under normal
circumstances blood flow and oxygen delivery are inextricably
coupled, but the use of hyperbaric conditions can change this
situation. Tissue swelling may persist in, for example,
joints for many years and SPECT imaging has now revealed that this is also true in the brain.
Clearly the appropriate time to use oxygen is at the start of a
disease process, not after a delay of months or years. Nevertheless, a
course of oxygen therapy sessions at increased pressure has been shown to resolve tissue swelling after the lapse of years.
It works by constricting blood vessels and interrupting the vicious cycle where oxygen lack leads to tissue swelling, which then leads to further
oxygen deficiency.
HBOTis not a miracle cure for children with cerebral palsy, it is simply a way of ensuring the most complete recovery possible.
It should be used with exercise programmes and other current forms of rehabilitation.
