Cortegiani Andrea, Foresta Grazia, Strano Giustino, Strano Maria Teresa, Montalto Francesca, Garbo Domenico, Raineri Santi Maurizio
Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anaesthesiology, Analgesia, Emergency and Intensive Care, Policlinico "P. Giaccone," University of Palermo, via del Vespro 129, 90127 Palermo, Italy.
Case Rep Med. 2013;2013:939704. doi: 10.1155/2013/939704. Epub 2013 Jul 22.
Dysbaric accidents are usually referred to compressed air-supplied diving. Nonetheless, some cases of decompression illness are known to have occurred among breath-hold (BH) divers also, and they are reported in the medical literature. A male BH diver (57 years old), underwater fishing champion, presented neurological disorders as dizziness, sensory numbness, blurred vision, and left frontoparietal pain after many dives to a 30-35 meters sea water depth with short surface intervals. Symptoms spontaneously regressed and the patient came back home. The following morning, pain and neurological impairment occurred again and the diver went by himself to the hospital where he had a generalized tonic-clonic seizure and lost consciousness. A magnetic resonance imaging of the brain disclofsed a cortical T1-weighted hypointense area in the temporal region corresponding to infarction with partial hemorrhage. An early hyperbaric oxygen therapy led to prompt resolution of neurological findings. All clinical and imaging characteristics were referable to the Taravana diving syndrome, induced by repetitive prolonged deep BH dives. The reappearance of neurological signs after an uncommon 21-hour symptom-free interval may suggest an atypical case of Taravana syndrome.
减压病通常与使用压缩空气的潜水有关。然而,也有一些减压病病例发生在屏气潜水员中,医学文献中有相关报道。一名57岁的男性屏气潜水员,是水下捕鱼冠军,在多次潜至30 - 35米深的海水且水面间隔时间较短后,出现了如头晕、感觉麻木、视力模糊和左额顶叶疼痛等神经系统症状。症状自行消退,患者回家。第二天早上,疼痛和神经功能障碍再次出现,潜水员自行前往医院,在医院发生了全身强直阵挛性癫痫发作并失去意识。脑部磁共振成像显示颞叶区域有一个皮质T1加权低信号区,对应梗死并伴有部分出血。早期高压氧治疗使神经症状迅速缓解。所有临床和影像学特征均符合反复长时间深度屏气潜水诱发的塔拉瓦纳潜水综合征。在一个罕见的21小时无症状间隔后神经症状再次出现,可能提示这是一例非典型的塔拉瓦纳综合征病例。