Hyperbaric Oxygen Brain Injury Treatment Trial

Inclusion Criteria:

• Age 16 years or older and 65 years or younger

• Present with severe TBI, defined as Glasgow Coma Scale (GCS) of 3 to 8.

• Marshall computerized tomography (CT) score >1 in patients with a GCS of 7 or 8 orpatients with an alcohol level >200 mg/dl

• Ability to initiate the first hyperbaric oxygen treatment within 8 hours ofadmission in patients not requiring a craniotomy/craniectomy or any other majorsurgical procedure OR

• Ability to initiate the first hyperbaric oxygen treatment within 14 hours ofadmission in patients requiring a craniotomy/craniectomy or major surgical procedure

Exclusion Criteria:

• First hyperbaric oxygen treatment cannot be initiated within 24 hours of injury

• GCS of 3 with mid-position and non-reactive pupils bilaterally (4mm)

• Penetrating head injury

• Pregnant

• Pre-existing neurologic disease (e.g. TBI or stroke or neurodegenerative disorder)with confounding residual neurologic deficits

• Unstable acute spinal cord injury

• Fixed coagulopathy

• Severe hypoxia

• Cardiopulmonary resuscitation performed

• Coma suspected to de due to primarily non-TBI causes

• Any contraindications to the study intervention