Chung Jae Myun, Ahn Jin Young
Department of Neurology, Inje University College of Medicine, Seoul, Korea.
Department of Neurology, Seoul Medical Center, Seoul, Korea.
Undersea Hyperb Med. 2017 Jan-Feb;44(1):57-62. doi: 10.22462/1.2.2017.9.
Decompression sickness may involve the central nervous system. The most common site is spinal cord. This study was conducted to determine the relationship between magnetic resonance(MR) imaging findings of spinal damage.
We conducted a retrospective review of 12 patients (male=10, female=2) who presented with spinal cord symptoms. We investigated their clinical features, neurological findings and radiologic findings.
The depth and bottom time of the dive were 34.5 meters (range 22-56) and 22.7 minutes (range 10-55) respectively. Most divers ascended within appropriate time frame as shown by the decompression tables. The most frequent initial symptoms were lower limb weakness (n=12), followed by sensory disturbances (n=10) and bladder dysfuction (n=5). The chief radiologic abnormalities were continuous (n=3), or non-continuous (n=5) high-signal intensity on T2-weighted images at posterior paramedian portion of the spinal cord, mainly thoracic level. There were no abnormal findings in the remaining four (4) patients, and they showed good prognosis. All patients were treated with hyperbaric oxygen therapy and some received high-dose dexamethasone. On discharge, five (5) patients had made a full recovery, seven (7) had some residual neurological sequelae, and all patients except one (1) regained normal bladder function.
Spinal cord decompression sickness is a neurological emergency. Early recognition and treatment may minimize neurological damage. Initial normal finding in MR imaging was a good predictor for prognosis in spinal decompression sickness.
减压病可能累及中枢神经系统。最常见的部位是脊髓。本研究旨在确定脊髓损伤的磁共振成像（MR）表现之间的关系。
我们对12例出现脊髓症状的患者（男性10例，女性2例）进行了回顾性研究。我们调查了他们的临床特征、神经学表现和放射学表现。
潜水深度和水底停留时间分别为34.5米（范围22 - 56米）和22.7分钟（范围10 - 55分钟）。如减压表所示，大多数潜水员在适当的时间范围内上升。最常见的初始症状是下肢无力（n = 12），其次是感觉障碍（n = 10）和膀胱功能障碍（n = 5）。主要的放射学异常是脊髓后正中部分在T2加权图像上出现连续（n = 3）或不连续（n = 5）的高信号强度，主要在胸段水平。其余4例患者无异常发现，且预后良好。所有患者均接受高压氧治疗，部分患者接受了大剂量地塞米松治疗。出院时，5例患者完全康复，7例有一些残留的神经后遗症，除1例患者外，所有患者膀胱功能恢复正常。
脊髓减压病是一种神经急症。早期识别和治疗可使神经损伤最小化。MR成像最初正常的表现是脊髓减压病预后的良好预测指标。
