ABSTRACT
We administered hyperbaric oxygen or air in a double-blind prospective protocol to 39 patients with ischemic cerebral infarction. We interrupted the study when we noticed what appeared to be a trend favoring the air-treated patients, whose neurological deficits were less severe (mean +/- SEM score on graded neurological examination: air, 25.6 +/- 4.9; oxygen, 34.5 +/- 7.5) and whose infarcts were smaller (air, 29.0 +/- 12.2 cm3; oxygen, 49.2 +/- 11.7 cm3) at 4 months. The trend, we decided, was probably an artifact of the randomization process. Nevertheless, we chose not to resume the trial because the treatment was difficult to administer by schedule (for various reasons the treatment protocol was broken in 15 of the 39 patients), was poorly tolerated (eight of the 39 patients refused to continue treatments), and did not produce dramatic improvement.
Subject(s)
Cerebrovascular Disorders/therapy , Hyperbaric Oxygenation , Adult , Aged , Aged, 80 and over , Air , Brain Ischemia/diagnostic imaging , Brain Ischemia/therapy , Cerebrovascular Disorders/diagnostic imaging , Double-Blind Method , Evaluation Studies as Topic , Humans , Middle Aged , Patient Acceptance of Health Care , Pilot Projects , Prospective Studies , Time Factors , Tomography, X-Ray ComputedABSTRACT
We report the detailed clinical and pathologic account of a patient with an ischemic infarction restricted to both medullary pyramids. Although prevailing neurophysiologic teachings would predict a flaccid paralysis, the patient's pure motor quadriplegia was eventually associated with spasticity.
