Relationship between clinical and radiologic findings of spinal cord injury in decompression sickness

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.

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The emulsified perfluorocarbon Oxycyte improves spinal cord injury in a swine model of decompression sickness

Spinal Cord ◽

10.1038/sc.2012.135 ◽

2012 ◽

Vol 51 (3) ◽

pp. 188-192 ◽

Cited By ~ 10

Author(s):

R T Mahon ◽

C R Auker ◽

S G Bradley ◽

A Mendelson ◽

A A Hall

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Decompression Sickness ◽

Swine Model ◽

Cord Injury

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MEK1/2 Inhibition Synergistically Enhances the Preventive Effects of Normobaric Oxygen on Spinal Cord Injury in Decompression Sickness Rats

Frontiers in Physiology ◽

10.3389/fphys.2021.674430 ◽

2021 ◽

Vol 12 ◽

Author(s):

Quan Zhou ◽

Xiangyang Meng ◽

Guoyang Huang ◽

Hongjie Yi ◽

Juan Zheng ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Motor Function ◽

Decompression Sickness ◽

Mapk Pathway ◽

Peak Time ◽

Spinal Cord Tissue ◽

Normobaric Oxygen ◽

Negative Regulatory Pathway ◽

Cord Injury

A previous study from our team found that hyperbaric oxygen (HBO) pretreatment attenuated decompression sickness (DCS) spinal cord injury by upregulating heat shock protein 32 (HSP32) via the ROS/p38 MAPK pathway. Meanwhile, a MEK1/2-negative regulatory pathway was also activated to inhibit HSP32 overexpression. The purpose of this study was to determine if normobaric oxygen (NBO) might effectively induce HSP32 while concurrently inhibiting MEK1/2 and to observe any protective effects on spinal cord injury in DCS rats. The expression of HSP32 in spinal cord tissue was measured at 6, 12, 18, and 24 h following NBO and MEK1/2 inhibitor U0126 pretreatment. The peak time of HSP32 was observed at 12 h after simulated air diving. Subsequently, signs of DCS, hindlimb motor function, and spinal cord and serum injury biomarkers were recorded. NBO-U0126 pretreatment significantly decreased the incidence of DCS, improved motor function, and attenuated oxidative stress, inflammatory response, and apoptosis in both the spinal cord and serum. These results suggest that pretreatment with NBO and U0126 combined can effectively alleviate DCS spinal cord injury in rats by upregulating HSP32. This may lead to a more convenient approach for DCS injury control, using non-pressurized NBO instead of HBO.

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