Treatment of mild traumatic brain injury by epidural saline and oxygen injection: report of two cases.

Mild traumatic brain injury (mTBI) is a common complication of minor head injury and a serious problem in the Iraq war returnees. Effective treatment is not yet available. We have treated 23 patients with chronic post-traumatic headache by epidural saline and oxygen injection (ESOI) with efficacy of 96 %. Among them, ten cases were cured. Two out of these cured cases fulfilled the criteria of mTBI and their improvement were objectively demonstrated by a TriIRIS C9000 (Hamamatsu Photonics K.K.) that can monitor the accommodation and convergence function simultaneously. We show the treatment protocol of ESOI and the clinical courses of the two cases in this paper. Both had symptoms somewhat similar to those of spontaneous intracranial hypotension. However, their intracranial pressure was not low and their symptoms were relieved immediately after removal of cerebrospinal fluid (CSF). Although symptoms of mTBI are believed to be attributed to brain damage, some symptoms may not be derived from brain damage itself, but from CSF circulation abnormalities. This is the first report of successfully treated mTBI by ESOI. The effectiveness of the treatment can be verified objectively by monitoring eye function. The outcome suggests that war returnees with mTBI can be treated -successfully by ESOI.