Mastaglia F L, McCallum R I, Walder D N
Clin Exp Neurol. 1983;19:54-9.
Four scuba divers and 2 professional deep sea divers developed spinal cord symptoms due to decompression sickness. Symptoms developed during or immediately after ascent in 4 cases and were delayed in 2. In 2 cases new symptoms appeared during a jet flight. In 4 cases paraparesis was associated with a sensory level in the mid or low dorsal region indicating the thoracic cord as the major site of involvement. In the other 2 cases the clinical findings were suggestive of combined lesions in the lower cervical and lumbar cord. Therapeutic recompression led to improvement in each case. Three cases who were re-examined after intervals of 3 to 7 years each showed residual corticospinal and minor sensory signs. One of these cases met with a violent death 3.5 years after the acute episode; examination of the cord showed multifocal white matter degeneration in the posterior and lateral columns between C7 and T4 with secondary ascending and descending tract degeneration. The mechanism of spinal cord damage in decompression sickness is discussed.
4名潜水员和2名职业深海潜水员因减压病出现了脊髓症状。4例症状在上升过程中或刚上升后出现，2例出现延迟。2例在乘坐喷气式飞机期间出现了新症状。4例中，双下肢轻瘫伴有中背部或下背部感觉平面，提示胸段脊髓是主要受累部位。另外2例的临床表现提示颈下段和腰段脊髓合并损伤。治疗性再加压使每例病情都有改善。3例分别在3至7年后接受复查，均显示有残留的皮质脊髓征和轻微感觉体征。其中1例在急性发作3.5年后遭遇暴力死亡；脊髓检查显示C7至T4之间的后柱和侧柱有多灶性白质变性，继发上下行传导束变性。本文讨论了减压病中脊髓损伤的机制。
