Cerebro-spinal decompression sickness: report of two cases.

STUDY DESIGN

Two case reports.

OBJECTIVE

To describe two unusual cases of deep diving followed by cerebro-spinal decompression sickness (DCS).

SETTING

Midlands Centre for Spinal Injuries, England.

METHODS

Observation of the outcome of two different cases of cerebro-spinal DCS, who have received two different modalities of treatment.

RESULTS

The first patient's symptoms developed after he surfaced, he was treated according to the US Navy treatment table 6. He also received steroids for almost 3 weeks. His MRI of the brain and spinal cord, which was performed within 24 h of injury did not show any abnormality, while a repeat MRI 3 weeks later revealed abnormal signals in the brain and spinal cord. The second patient's symptoms started before he surfaced, he was treated with Comex 30 treatment table for 14 days and received no steroids, his MRI was performed 3 days after the injury showed high signals in the brain and spinal cord.

CONCLUSION

Both divers developed cerebro-spinal dysfunction. They had encephalopathy (manifested by loss of consciousness), which indicates bilateral cerebral dysfunction. DCS can occur even when dives are conducted according to the procedures described by the US Navy. The use of high-dose steroids has not been formally tested in DCS; their use is controversial.