Abstract
Study Design
Case report.
Objective
To describe an unusual case of deep diving followed by spinal cord injury due to decompression sickness (DCS).
Setting
Princess Royal Spinal Injuries Centre, Sheffield Teaching Hospitals NHS Foundation Trust, England.
Method
Description and observation of management and outcomes, of spinal decompression sickness (DCS).
Results
The patient's symptoms and signs developed after she surfaced after a deep sea diving event. She was managed and treated in a tertiary level care hospital. MRI performed within 24 hours, showed signs of increased signal intensity in the cervical and thoracolumbar regions. She was treated with hyperbaric oxygen which improved her pain symptoms but there was no immediate resolution in motor sensory deficits. Repeat MRI done after a week showed resolution if hyperintensity in the cervical region but not in the thoracolumbar region. Patient progressed to have significant neurological recovery in the next 6 months. She became ambulant with unilateral ankle foot orthotic and a pair of crutches, she continued to have bladder incontinence at 1 year follow-up interval.
Conclusion
Central nervous involvement is not uncommon in decompression sickness in divers. Early diagnosis and proper management can reduce acute symptoms and prevent further complications of permanent neurological disability. Primary prevention by education and adhering to standard diving guidelines is needed to reduce mortality and morbidity in decompression sickness.
Spinal cord degeneration associated with type II decompression sickness: case report