This article reviews the first case of successful treatment for post-anesthesia dementia with peri-spinal etanercept injection combined with hyperbaric oxygen therapy. The patient was a 77-year-old Caucasian man of Mexican ethnicity who presented to clinic 4.5 years after a knee replacement surgery. Immediately post-surgery, the patient began to show dramatic cognitive, physical, and emotional impairment compared with his presurgical state; these symptoms were still present when he arrived at the clinic.
A clinical assessment and brain single-photon emission computer tomography were performed. Diagnoses of dementia with major cognitive deficits and aphasia were established. A 40-session course of hyperbaric oxygen therapy was initiated to address our patient’s impairments. After the first ten hyperbaric oxygen therapy treatments, the patient was administered 25 mg perispinal etanercept injections approximately once weekly for 5 months. Starting after the first peri-spinal etanercept injection, the patient began showing progressive improvements. By the 5-month follow-up, the patient’s cognitive and physical function were substantially restored. A follow-up
single-photon emission computer tomography scan showed increased perfusion in several small, localized areas.
Conclusion. In this case of dementia and major cognitive disorder post major surgery and anesthesia, the very beneficial effect of combining hyperbaric oxygen therapy with peri-spinal etanercept is outlined.
Steve Best and Dan G. Pavel, Journal of Medical Case Reports (2017) 11:105 DOI 10.1186/s13256-017-1259-6
