Hydrogen inhalation promotes recovery of a patient in persistent vegetative state from intracerebral hemorrhage: A case report and literature review

Figure 1 Effects of hydrogen therapy. A, C, and E: Severe and large-scale hemorrhage before treatment was observed in the left hemisphere, including significantly reduced computed tomography (CT) image density that covered the left prefrontal and parietal regions and the majority of the occipital gyrus; the left lateral ventricle was significantly enlarged compared to the right ventricle, and the midline brain structures also deviated from the normal position due to the hematoma and brain edema; B, D, and F: After treatment, the left hemisphere was significantly damaged by hemorrhage with a markedly enlarged left lateral ventricle and severe cerebral atrophy. However, significantly alleviated cerebral softening was observed in the right hemisphere, revealed by an increased CT number (Hounsfield units) in multiple brain regions (yellow circles), compared to those of similar brain regions (yellow circles) before treatment. The neuropathology stabilized in the left hemisphere and was alleviated in the right hemisphere after hydrogen gas inhalation treatment.

Figure 2 Schematic overview of the clinical progress in the improvement in Coma Recovery Scale-Revised scores and the recovery from persistent vegetative state in this patient. The patient failed to respond to brain surgery and brain protection and rehabilitation for nearly 2 mo. One month after hydrogen gas inhalation treatment, the Coma Recovery Scale-Revised (CRS-R) score of the patient increased from 3 to 6. After 2 more months of treatment, the patient’s consciousness was significantly restored and showed greater subsequent improvements with significantly improved motor function, the ability to speak and express requests, and general health. By the end of the 5-mo treatment period with hydrogen gas inhalation, the patient had nearly recovered and stabilized to a normal consciousness state with a CRS-R score of 22. CRS-R: Coma Recovery Scale-Revised.