Spinal cord decompression sickness associated with SCUBA (Self-contained underwater breathing apparatus) diving

Abstract

We present 2 comparatively rare cases of spinal cord decompression sickness (SCDS) associated with scuba (self-contained underwater breathing apparatus) -diving. A 39-year-old man and a 43-year-old man, both professional divers, presented with neurological deficits after over 1 hour from the beginning of a scuba-diving session. Neurological deficits occurred acutely in one case, and in the other case appeared gradually. We gave both patients emergency hyperbaric oxygen (HBO) therapy within 24 hours. They were almost completely ADL (activity of daily living) after a long rehabilitation. The pathophysiology of SCDS is not completely understood, but is behaved to be mainly due to arterial gas embolism and venous infarction. It is difficult to understand how venous congestion could be origin, if the white matter of the upper or middle thoracic cord segment is affected most frequently. We describe herein MRI evaluated SCDS.