Nota Clínica

Acute myelopathy in a diver caused by decompression sickness. A case description and a survey of the literature

F.J. Carod-Artal, S.V Nunes, T.V. Fernandes-Silva [REV NEUROL 2003;36:1040-1044] PMID: 12808500 DOI: https://doi.org/10.33588/rn.3611.2003012

OPEN ACCESS

Volumen 36 | Number 11 | Nº of views of the article 6.395 | Nº of PDF downloads 374 | Article publication date 01/06/2003

Download PDF Castellano Citation Search in PubMed

Share in:

Go to another issue

ABSTRACT

INTRODUCTION Decompression sickness (DS) is caused when bubbles of an inert gas –usually nitrogen, since oxygen is metabolised in the tissues– are released into the bloodstream and tissues during fast ascents once the atmospheric pressure is lowered near the surface. Neurological complications are its most serious form of expression and include vertigo, headache, stroke and acute myelopathy, among others. DS that affects the spinal cord is infrequent.

CASE REPORT A male, 42 years old, who presented progressive tetraparesis 15 minutes after returning to the surface following several immersions up to 40 metres deep in the same day. Neurological exploration revealed tetraparesis that was predominantly distal and in the lower limbs, a posterior cord syndrome, urinary incontinence and neurogenic pain. Total column magnetic resonance imaging showed areas of diffused hypersignal in the T2 sequence in the thoracic and cervical (C2 to C6) regions, predominating in the posterior cords. The echocardiogram, transcranial Doppler and spirometric studies ruled out an arterial gas embolism following pulmonary barotrauma.

CONCLUSIONS Spinal DS can give rise to a serious myelopathy, which affects the pyramidal pathway, posterior cords and sphincteral control, and which generally appears after sudden ascents from the deep dives. KeywordsDecompression illness Decompression sickness Diving Mielopathy Spinal cord injury thy

FULL TEXT (solo disponible en lengua castellana / Only available in Spanish)

Acceso directo al último número

Último Podcast

Nota Clínica

Acute myelopathy in a diver caused by decompression sickness. A case description and a survey of the literature