Department of Neurosurgery, University of South Florida, Tampa, Florida, USA.
Department of Neurosurgery, University of South Florida, Tampa, Florida, USA.
World Neurosurg. 2020 Sep;141:153-156. doi: 10.1016/j.wneu.2020.06.030. Epub 2020 Jun 12.
Decompression illness often presents with a wide variety of vague neurologic symptoms. Animal models have suggested that intracranial hemorrhages may result from nitrogen bubble ischemic insults. However, there is a paucity of cases and no known case reported to date of non-aneurysmal subarachnoid hemorrhage after rapid ascension from diving.
A 60-year-old man presented with headache, nausea, emesis, and confusion 2 days after ascending rapidly from scuba diving. Given the severity and his symptoms unremitting despite oxygen at home, a computed tomography scan of the head was obtained revealing a prepontine and right sylvian fissure subarachnoid hemorrhage with ventriculomegaly. No underlying vascular abnormality was discovered. The patient was discharged from the hospital posthemorrhage day 7, neurologically intact.
In patients presenting with persistent headache, nausea, emesis and/or other neurologic symptoms after diving, health care providers should consider intracranial hemorrhage in their work up.
减压病常表现为多种模糊的神经系统症状。动物模型表明，颅内出血可能是由于氮气泡缺血性损伤所致。然而，目前病例较少，也没有已知的潜水后快速上升导致非动脉瘤性蛛网膜下腔出血的病例报告。
一名 60 岁男性在快速潜水上升后 2 天出现头痛、恶心、呕吐和意识混乱。鉴于其病情严重且症状持续存在，尽管在家中吸氧，仍进行了头部计算机断层扫描，显示桥前池和右侧大脑外侧裂蛛网膜下腔出血伴脑室扩大。未发现潜在的血管异常。患者在出血后第 7 天出院，神经功能完整。
在潜水后出现持续头痛、恶心、呕吐和/或其他神经系统症状的患者中，医疗保健提供者应在其检查中考虑颅内出血。
