In recent years there is growing evidence about the long-term consequences of brain injuries amongst Firefighters. Firefighters are repeatedly exposed to mechanical and blast brain injuries that can culminate in chronic unremittable cognitive decline, the so-called post-concussion syndrome. In addition, Firefighters are also being repeatedly exposed to severe emotional stress that can lead to the development of Post-Traumatic Stress Disorder (PTSD). The combination of these two types of brain injuries may contribute to the growing number of suicides amongst Firefighters who stand in the front of our civil society.

Clinical studies done in recent years present convincing evidence that hyperbaric oxygen therapy (HBOT) can be the coveted neurotherapeutic treatment for neurological incidents like traumatic brain injury and PTSD. This new understanding leads to a paradigm change in the way that we refer to chronic brain injuries; from now these should be thought of like other non-healing wounds in other parts of the body (e.g. non-healing leg ulcers). Even though many of the beneficial effects of HBOT can be explained by the improvement of tissue oxygenation, it is now realized that intermittent increase of oxygen concentration can induce many of the mediators and cellular mechanism that are usually induced during hypoxia but without the hazardous hypoxia, termed “The Hyperoxic-Hypoxic Paradox”. The intermittent hyperoxic exposure during HBOT can trigger stem cells proliferation, brain angiogenesis and neurogenesis.

In this lecture we will discuss the mechanisms and long-term consequences of brain injuries amongst fire fighters and the new approach to treating "brain wounds" with hyperbaric oxygen therapy. This new understanding and treatment strategy can bring hope to the growing number of brain-injured fire fighters who needs it.