To discuss the effect of hyperbaric oxygen (HBO) in elderly patients with postoperative brain re-expansion of bilateral chronic subdural hematoma (CSDH) at middle and high altitude areas.

The clinical data of 84 elderly patients, admitted to Department of Neurosurgery, People Hospital of Qinghai Province from Jan 2010 to Dec 2017, with bilateral CSDH living at middle and high altitudes were selected and divided into control group and observation group according to random number table method. Forty-one cases in the control group received routine treatment after bilateral puncture and drainage, while 43 cases in the observation group received hyperbaric oxygen therapy on the basis of routine treatment after operation. According to the maximum thickness (T) of the residual cavity of cranial CT hematoma after operation, the degree of brain re-expansion was divided into 4 grades (I-IV). The differences of the degree of brain re-expansion were compared between the 2 groups in one month and two months after operation.

One month after operation, the thickness of the subdural residual cavity measured by the two groups after cranial CT re-expansion showed that the degree of brain re-expansion in the observation group was higher than that in the control group, and the difference was statistically significant (P=0.002). Two months after operation, the thickness of the subdural residual cavity measured by the two groups after cranial CT re-expansion showed that the degree of brain re-expansion in the observation group was also higher than that in the control group, the difference was statistically significant (P=0.001).

HBO therapy can effectively promote postoperative brain re-expansion of bilateral CSDH at middle and high altitude areas. It can be used as a routine auxiliary treatment for CSDH after operation in plateau area.