Ye ZX, Fu XX, Wu YZ, Lin L, Xie LQ, Hu YL, Zhou Y, You ZG, Lin H. Paradoxical herniation associated with hyperbaric oxygen therapy after decompressive craniectomy: A case report. World J Clin Cases 2024; 12(10): 1793-1798 [PMID: 38660069 DOI: 10.12998/wjcc.v12.i10.1793]
Corresponding Author of This Article
Hai Lin, PhD, Associate Chief Physician, Department of Neurosurgery, The Second People's Hospital of Fujian Province (The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine), No. 282 Wusi Road, Fuzhou 350001, Fujian Province, China. 461898474@qq.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 6, 2024; 12(10): 1793-1798 Published online Apr 6, 2024. doi: 10.12998/wjcc.v12.i10.1793
Paradoxical herniation associated with hyperbaric oxygen therapy after decompressive craniectomy: A case report
Zhong-Xing Ye, Xin-Xin Fu, Yang-Zong Wu, Ling Lin, Liang-Qi Xie, Yu-Ling Hu, Yi Zhou, Zhu-Gui You, Hai Lin
Zhong-Xing Ye, Xin-Xin Fu, Ling Lin, Liang-Qi Xie, Yu-Ling Hu, Yi Zhou, Hai Lin, Department of Neurosurgery, The Second People's Hospital of Fujian Province (The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine), Fuzhou 350001, Fujian Province, China
Yang-Zong Wu, Department of Neurosurgery, The Second Hospital of Longyan, Longyan 364000, Fujian Province, China
Zhu-Gui You, Department of Neurosurgery, Zhangping City Hospital, Longyan 364400, Fujian Province, China
Author contributions: Ye ZX, Fu XX, Wu YZ, Lin L, Xie LQ, Hu YL, and Zhou Y designed the research study; Ye ZX, Fu XX, Wu YZ, and Lin L performed the research; You ZG analyzed the data; Lin H analyzed the data and wrote the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai Lin, PhD, Associate Chief Physician, Department of Neurosurgery, The Second People's Hospital of Fujian Province (The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine), No. 282 Wusi Road, Fuzhou 350001, Fujian Province, China. 461898474@qq.com
Received: October 29, 2023 Peer-review started: October 29, 2023 First decision: January 17, 2024 Revised: February 3, 2024 Accepted: March 12, 2024 Article in press: March 12, 2024 Published online: April 6, 2024 Processing time: 148 Days and 17.7 Hours
Abstract
BACKGROUND
Whether hyperbaric oxygen therapy (HBOT) can cause paradoxical herniation is still unclear.
CASE SUMMARY
A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery. HBOT was administered 22 d after surgery due to speech impairment. Paradoxical herniation appeared on the second day after treatment, and the patient’s condition worsened after receiving mannitol treatment at the rehabilitation hospital. After timely skull repair, the paradoxical herniation was resolved, and the patient regained consciousness and had a good recovery as observed at the follow-up visit.
CONCLUSION
Paradoxical herniation is rare and may be caused by HBOT. However, the underlying mechanism is unknown, and the understanding of this phenomenon is insufficient. The use of mannitol may worsen this condition. Timely skull repair can treat paradoxical herniation and prevent serious complications.
Core Tip: Paradoxical herniation may be caused by high-pressure oxygen therapy after decompressive craniectomy has not been reported. Paradoxical herniation has been misdiagnosed by the neurosurgery department of subordinate hospitals and provincial neurological rehabilitation hospitals for many times, thus delaying treatment. This report is to improve the understanding of paradoxical herniation.
