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When a person suffers a blow to the head, the acceleration/deceleration forces involved cause the brain to literally bounce off the inside of the skull, producing what is essentially a bruise. The brain is a soft putty-like organ suspended by membranes in the skull, cushioned by cerebrospinal fluid.

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Like a bruise anywhere in the body, the injury triggers an inflammatory response that is larger than the original injury. But the brain can't swell because it is inside the skull, so pressure builds up in the inflamed area, reducing blood flow and damaging neurons to the point that they can't transmit nerve impulses—yet they don't necessarily die. This inflammatory process may take a week or two to peak, which explains why the symptoms of concussion often continue to worsen for several weeks after the injury. We now know that this condition of a large area of injured "idling" cells can persist indefinitely.

 

HBOT, even when done years or decades after the injury, improves circulation and oxygenation of the injured areas, allowing them to heal. This explains why treatment with HBOT can dramatically improve symptoms that have been stable for long periods of time.

 

Whatever improvement comes about in this situation will generally be permanent. However, recent research shows that most of the damage that occurs from a concussion is the result of the prolonged inflammatory process that follows the accident, not the injury sustained at the time of the accident.

 

We now know that if HBOT can be started within hours of the injury, or at most within a day or two, most of the damage can be prevented and long-term deficits may be avoided. It is unfortunate that very few concussion patients have this opportunity.

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**Timing of Treatment:**
Benefit can occur months, even years or decades after the injury—therefore it is always worth trying HBOT. However, if HBOT can be initiated immediately after injury, within hours or days, much of the damage can be avoided altogether.