Background
Decompression sickness may involve the central nervous system, and the most common site is spinal cord. This study was conducted to determine the relationship between magnetic resonance (MR) imaging findings of spinal damage and clinical findings in acute decompression sickness.
Methods
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.
Results
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 limbs weakness (n=12), followed by sensory disturbances (n=10) and bladder dysfunction (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 remaining 4 patients and they showed good prognosis. All patients were treated with hyperbaric oxygen therapy and some received high dose dexamethasone. On discharge, 5 patients had made a full recovery, 7 had some residual neurological sequelae, and most patients except one regained normal bladder function.
Conclusions
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 redictor for prognosis in spinal decompression sickness.
