Myelopathy associated with decompression sickness: a report of six cases.

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.