Abstract

SAQUISELA, Víctor V et al. Spinal cord decompression sickness: Ischemic myelopathy secondary to a diving accident. Rev Neuropsiquiatr [online]. 2018, vol.81, n.1, pp.42-46. ISSN 0034-8597.  http://dx.doi.org/https://doi.org/10.20453/rnp.v81i1.3272.

We report the case of a 34-year-old male patient, a professional diver hospitalized in connection with a clinical picture characterized by sudden onset of disorientation, generalized weakness, intense body pain followed by sudden paraplegia and urinary retention. These manifestations occurred after a rapid ascent (10 minutes) from a depth of about 42 meters. He was admitted after having received two sessions of decompression therapy. Physical examination revealed flaccid paraplegia, bilateral extensor plantar reflex, a D5 sensitive level. Magnetic resonance imaging showed an increase in the medullar gauge with alteration of its signal, both in anterior and posterior areas, seen as a heterogeneous hyperintensity in the sequence T2 and STIR from D2 to D11, without dilatation of the spinal canal, compatible with ischemic injury. The diagnosis of ischemic myelopathy secondary to decompressive disease was made, and the patient received treatment with a hyperbaric chamber and a short course of steroids (Methylprednisolone 1g EV for 5 days) with partial response.The case is presented, and comments are made regarding the low incidence of this pathology and the variety of clinical peculiarities in its presentation.

Keywords : Decompression sickness; spinal cord diseases; diving.

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