{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T23:12:45Z","timestamp":1780701165408,"version":"3.54.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010109","name":"Medical University of Graz","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010109","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurosurg Rev"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Brain abscesses are still characterized by substantial case fatality rates and a high risk of permanent functional impairment. Standard treatment consists of long-term antimicrobial therapy and various neurosurgical interventions. In a few institutions, hyperbaric oxygen therapy (HBOT) is used as an additional treatment modality. The purpose of this study was to evaluate the effects of adjuvant HBOT on neurological and radiological outcomes in patients with brain abscesses. 55 patients with brain abscesses treated at the Medical University Clinic of Graz between 2004 and 2022 were included in this retrospective analysis. Thirty patients (54.5%) received standard therapy, consisting of long-term antimicrobial therapy and at least one neurosurgical intervention. Twenty-five patients (45.5%) additionally underwent HBOT. After three months, 24% of patients in the HBOT group and 10% in the non-HBOT group exhibited no residual abscess or pathological enhancement; at six-month follow-up, the percentage increased to 80% in the HBOT group compared to 46.7% in the non-HBOT group (p\u2009=\u20090.009). At 12-month follow-up, a symptom-free status (modified Rankin Scale 0) was attained by 60% of HBOT group patients and 30% of non-HBOT group patients (p\u2009=\u20090.046). The 12-month mortality rates for HBOT and non-HBOT groups were 12% (n\u2009=\u20093) and 20% (n\u2009=\u20096), respectively. No adverse effects related to HBOT were noted. Adjuvant HBOT significantly improved radiological outcome after 6\u00a0months, neurological outcome after 12\u00a0months and reduced mortality. HBOT may be taken into consideration in all patients with brain abscesses, particularly in cases with deep seated or multiple lesions and when antimicrobial and surgical treatment had failed.<\/jats:p>","DOI":"10.1007\/s10143-025-03721-9","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:57:57Z","timestamp":1753837077000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hyperbaric oxygen therapy for brain abscesses: A useful adjuvant treatment for a faster recovery"],"prefix":"10.1007","volume":"48","author":[{"given":"A.","family":"Brunner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Lindenmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Pistracher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Micko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pichler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Enzinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Smolle-J\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Wolfsberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kurschel-Lackner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"issue":"9","key":"3721_CR1","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1212\/WNL.0000000000000172","volume":"82","author":"MC Brouwer","year":"2014","unstructured":"Brouwer MC, Coutinho JM, van de Beek D (2014) Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology 82(9):806\u2013813. https:\/\/doi.org\/10.1212\/WNL.0000000000000172","journal-title":"Neurology"},{"issue":"1","key":"3721_CR2","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/QCO.0000000000000334","volume":"30","author":"MC Brouwer","year":"2017","unstructured":"Brouwer MC, van de Beek D (2017) Epidemiology, diagnosis, and treatment of brain abscesses. Curr Opin Infect Dis 30(1):129\u2013134. https:\/\/doi.org\/10.1097\/QCO.0000000000000334","journal-title":"Curr Opin Infect Dis"},{"key":"3721_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-332","volume":"12","author":"J Helweg-Larsen","year":"2012","unstructured":"Helweg-Larsen J, Astradsson A, Richhall H et al (2012) Pyogenic brain abscess, a 15-year survey. BMC Infect Dis 12:332. https:\/\/doi.org\/10.1186\/1471-2334-12-332","journal-title":"BMC Infect Dis"},{"issue":"7\u20138","key":"3721_CR4","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/j.neurol.2019.07.002","volume":"175","author":"M Cantiera","year":"2019","unstructured":"Cantiera M, Tattevin P, Sonneville R (2019) Brain abscess in immunocompetent adult patients. Rev Neurol 175(7\u20138):469\u2013475. https:\/\/doi.org\/10.1016\/j.neurol.2019.07.002","journal-title":"Rev Neurol"},{"issue":"9","key":"3721_CR5","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.cmi.2017.05.004","volume":"23","author":"R Sonneville","year":"2017","unstructured":"Sonneville R, Ruimy R, Benzonana N et al (2017) An update on bacterial brain abscess in immunocompetent patients. Clin Microbiol Infect 23(9):614\u2013620. https:\/\/doi.org\/10.1016\/j.cmi.2017.05.004","journal-title":"Clin Microbiol Infect"},{"issue":"6","key":"3721_CR6","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1086\/511645","volume":"44","author":"S Dupuis-Girod","year":"2007","unstructured":"Dupuis-Girod S, Giraud S, Decullier E et al (2007) Hemorrhagic hereditary telangiectasia (Rendu-Osler disease) and infectious diseases: an underestimated association. Clin Infect Dis 44(6):841\u2013845. https:\/\/doi.org\/10.1086\/511645","journal-title":"Clin Infect Dis"},{"issue":"6","key":"3721_CR7","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1097\/CCM.0b013e3182120b41","volume":"39","author":"R Sonneville","year":"2011","unstructured":"Sonneville R, Mirabel M, Hajage D et al (2011) Neurologic complications and outcomes of infective endocarditis in critically ill patients: the ENDOcardite en REAnimation prospective multicenter study. Crit Care Med 39(6):1474\u20131481. https:\/\/doi.org\/10.1097\/CCM.0b013e3182120b41","journal-title":"Crit Care Med"},{"issue":"4","key":"3721_CR8","doi-asserted-by":"publisher","first-page":"590","DOI":"10.3171\/jns.1981.55.4.0590","volume":"55","author":"RH Britt","year":"1981","unstructured":"Britt RH, Enzmann DR, Yeager AS (1981) Neuropathological and computerized tomographic findings in experimental brain abscess. J Neurosurg 55(4):590\u2013603. https:\/\/doi.org\/10.3171\/jns.1981.55.4.0590","journal-title":"J Neurosurg"},{"issue":"4","key":"3721_CR9","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1227\/00006123-198804000-00017","volume":"22","author":"S Stephanov","year":"1988","unstructured":"Stephanov S (1988) Surgical treatment of brain abscess. Neurosurgery 22(4):724\u2013730. https:\/\/doi.org\/10.1227\/00006123-198804000-00017","journal-title":"Neurosurgery"},{"issue":"8","key":"3721_CR10","first-page":"657","volume":"70","author":"RE Pelosi","year":"1973","unstructured":"Pelosi RE (1973) Brain abscess. J Med Soc N J 70(8):657\u2013663","journal-title":"J Med Soc N J"},{"issue":"1","key":"3721_CR11","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s00381-005-1147-z","volume":"22","author":"S Kurschel","year":"2006","unstructured":"Kurschel S, Mohia A, Weigl V, Eder HG (2006) Hyperbaric oxygen therapy for the treatment of brain abscess in children. Childs Nerv Syst 22(1):38\u201342. https:\/\/doi.org\/10.1007\/s00381-005-1147-z","journal-title":"Childs Nerv Syst"},{"issue":"2","key":"3721_CR12","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1093\/cid\/cir797","volume":"54","author":"M Al Masalma","year":"2012","unstructured":"Al Masalma M, Lonjon M, Richet H et al (2012) Metagenomic analysis of brain abscesses identifies specific bacterial associations. Clin Infect Dis 54(2):202\u2013210. https:\/\/doi.org\/10.1093\/cid\/cir797","journal-title":"Clin Infect Dis"},{"issue":"9","key":"3721_CR13","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1086\/597578","volume":"48","author":"M Al Masalma","year":"2009","unstructured":"Al Masalma M, Armougom F, Scheld WM et al (2009) The expansion of the microbiological spectrum of brain abscesses with use of multiple 16S ribosomal DNA sequencing. Clin Infect Dis 48(9):1169\u20131178. https:\/\/doi.org\/10.1086\/597578","journal-title":"Clin Infect Dis"},{"issue":"5","key":"3721_CR14","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1016\/j.wneu.2011.03.048","volume":"76","author":"TE Ratnaike","year":"2011","unstructured":"Ratnaike TE, Das S, Gregson BA, Mendelow AD (2011) A review of brain abscess surgical treatment\u201378 years: aspiration versus excision. World Neurosurg 76(5):431\u2013436. https:\/\/doi.org\/10.1016\/j.wneu.2011.03.048","journal-title":"World Neurosurg"},{"issue":"7","key":"3721_CR15","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1007\/s00701-016-2809-1","volume":"158","author":"J Bartek Jr","year":"2016","unstructured":"Bartek J Jr, Jakola AS, Skyrman S et al (2016) Hyperbaric oxygen therapy in spontaneous brain abscess patients: a population-based comparative cohort study. Acta Neurochir 158(7):1259\u20131267. https:\/\/doi.org\/10.1007\/s00701-016-2809-1","journal-title":"Acta Neurochir"},{"issue":"21","key":"3721_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222111754","volume":"22","author":"J Lindenmann","year":"2021","unstructured":"Lindenmann J, Smolle C, Kamolz LP et al (2021) Survey of molecular mechanisms of hyperbaric oxygen in tissue repair. Int J Mol Sci 22(21):11754. https:\/\/doi.org\/10.3390\/ijms222111754","journal-title":"Int J Mol Sci"},{"key":"3721_CR17","unstructured":"Das JM, Tommeraasen MA, Cooper JS. (2022) Hyperbaric evaluation and treatment of intracranial abscess. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL). Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK493227\/."},{"key":"3721_CR18","unstructured":"Harmon S Hyperbaric oxygen therapy and intracranial abscess. Undersea & Hyperbaric Medical Society. Published March 28, 2021. https:\/\/www.uhms.org\/8-intracranial-abscess.html. Accessed 20 July 2022"},{"key":"3721_CR19","unstructured":"Zhang JH (2008) Hyperbaric Oxygen for Neurological Disorders. 1st edition. Best Publishing Company"},{"issue":"10","key":"3721_CR20","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1179\/1743132812Y.0000000091","volume":"34","author":"I Bilic","year":"2012","unstructured":"Bilic I, Petri NM, Krstulja M et al (2012) Hyperbaric oxygen is effective in early stage of healing of experimental brain abscess in rats. Neurol Res 34(10):925\u2013931. https:\/\/doi.org\/10.1179\/1743132812Y.0000000091","journal-title":"Neurol Res"},{"issue":"6","key":"3721_CR21","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.1161\/STROKEAHA.114.005116","volume":"45","author":"Q Hu","year":"2014","unstructured":"Hu Q, Liang X, Chen D et al (2014) Delayed hyperbaric oxygen therapy promotes neurogenesis through reactive oxygen species\/hypoxia-inducible factor-1\u03b1\/\u03b2-catenin pathway in middle cerebral artery occlusion rats. Stroke 45(6):1807\u20131814. https:\/\/doi.org\/10.1161\/STROKEAHA.114.005116","journal-title":"Stroke"},{"issue":"26","key":"3721_CR22","doi-asserted-by":"publisher","first-page":"E1349","DOI":"10.1097\/BRS.0000000000000005","volume":"38","author":"J Yang","year":"2013","unstructured":"Yang J, Liu X, Zhou Y et al (2013) Hyperbaric oxygen alleviates experimental (spinal cord) injury by downregulating HMGB1\/NF-\u03baB expression. Spine 38(26):E1349\u2013E1354. https:\/\/doi.org\/10.1097\/BRS.0000000000000005","journal-title":"Spine"},{"key":"3721_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2019.117170","volume":"241","author":"C Chen","year":"2020","unstructured":"Chen C, Chen W, Nong Z et al (2020) Hyperbaric oxygen alleviated cognitive impairments in mice induced by repeated cerebral ischemia-reperfusion injury via inhibition of autophagy. Life Sci 241:117170. https:\/\/doi.org\/10.1016\/j.lfs.2019.117170","journal-title":"Life Sci"},{"issue":"2","key":"3721_CR24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.22462\/3.4.2017.5","volume":"44","author":"L Xue","year":"2017","unstructured":"Xue L, Wang WL, Li Y et al (2017) Effects of hyperbaric oxygen on hippocampal neuronal apoptosis in rats with acute carbon monoxide poisoning. Undersea Hyperb Med 44(2):83\u201390. https:\/\/doi.org\/10.22462\/3.4.2017.5","journal-title":"Undersea Hyperb Med"},{"key":"3721_CR25","doi-asserted-by":"publisher","first-page":"369","DOI":"10.2147\/NDT.S183632","volume":"15","author":"H He","year":"2019","unstructured":"He H, Li X, He Y (2019) Hyperbaric oxygen therapy attenuates neuronal apoptosis induced by traumatic brain injury via Akt\/GSK3\u03b2\/\u03b2-catenin pathway. Neuropsychiatr Dis Treat 15:369\u2013375. https:\/\/doi.org\/10.2147\/NDT.S183632","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"1","key":"3721_CR26","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s00221-021-06249-8","volume":"240","author":"A Xia","year":"2022","unstructured":"Xia A, Huang H, You W et al (2022) The neuroprotection of hyperbaric oxygen therapy against traumatic brain injury via NF-\u03baB\/MAPKs-CXCL1 signaling pathways. Exp Brain Res 240(1):223\u2013232. https:\/\/doi.org\/10.1007\/s00221-021-06249-8","journal-title":"Exp Brain Res"},{"issue":"1","key":"3721_CR27","doi-asserted-by":"publisher","first-page":"24","DOI":"10.28920\/dhm47.1.24-32","volume":"47","author":"D Mathieu","year":"2017","unstructured":"Mathieu D, Marroni A, Kot J (2017) Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med 47(1):24\u201332. https:\/\/doi.org\/10.28920\/dhm47.1.24-32","journal-title":"Diving Hyperb Med"},{"issue":"3","key":"3721_CR28","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1002\/pbc.21814","volume":"52","author":"H Lackner","year":"2009","unstructured":"Lackner H, Sovinz P, Benesch M et al (2009) Management of brain abscesses in children treated for acute lymphoblastic leukemia. Pediatr Blood Cancer 52(3):376\u2013380. https:\/\/doi.org\/10.1002\/pbc.21814","journal-title":"Pediatr Blood Cancer"},{"issue":"1","key":"3721_CR29","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1128\/JCM.01456-10","volume":"49","author":"P Maritschnegg","year":"2011","unstructured":"Maritschnegg P, Sovinz P, Lackner H et al (2011) Granulomatous amebic encephalitis in a child with acute lymphoblastic leukemia successfully treated with multimodal antimicrobial therapy and hyperbaric oxygen. J Clin Microbiol 49(1):274\u2013276. https:\/\/doi.org\/10.1128\/JCM.01456-10","journal-title":"J Clin Microbiol"},{"issue":"Suppl 2","key":"3721_CR30","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1227\/01.neu.0000316257.21478.5b","volume":"62","author":"M Kutlay","year":"2008","unstructured":"Kutlay M, Colak A, Yildiz S et al (2008) Stereotactic aspiration and antibiotic treatment combined with hyperbaric oxygen therapy in the management of bacterial brain abscesses. Neurosurgery 62(Suppl 2):527\u2013535. https:\/\/doi.org\/10.1227\/01.neu.0000316257.21478.5b","journal-title":"Neurosurgery"},{"key":"3721_CR31","doi-asserted-by":"publisher","unstructured":"Widdrington JD, Bond H, Schwab U et al (2018) Pyogenic brain abscess and subdural empyema: presentation, management, and factors predicting outcome. Infection 46(6):873\u2013879. https:\/\/doi.org\/10.1007\/s15010-018-1182-9","DOI":"10.1007\/s15010-018-1182-9"}],"container-title":["Neurosurgical Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-025-03721-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10143-025-03721-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10143-025-03721-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T04:14:29Z","timestamp":1772079269000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10143-025-03721-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3721"],"URL":"https:\/\/doi.org\/10.1007\/s10143-025-03721-9","relation":{},"ISSN":["1437-2320"],"issn-type":[{"value":"1437-2320","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"assertion":[{"value":"19 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 May 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.For this type of study formal consent is not required. The analysis was approved by the local institutional review board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"583"}}