Cerebro-spinal decompression sickness: report of two cases.
METHODS
Two case reports.


OBJECTIVE
To describe two unusual cases of deep diving followed by cerebro-spinal decompression sickness (DCS).


METHODS
Midlands Centre for Spinal Injuries, England.


METHODS
Observation of the outcome of two different cases of cerebro-spinal DCS, who have received two different modalities of treatment.


RESULTS
The first patient's symptoms developed after he surfaced, he was treated according to the US Navy treatment table 6. He also received steroids for almost 3 weeks. His MRI of the brain and spinal cord, which was performed within 24 h of injury did not show any abnormality, while a repeat MRI 3 weeks later revealed abnormal signals in the brain and spinal cord. The second patient's symptoms started before he surfaced, he was treated with Comex 30 treatment table for 14 days and received no steroids, his MRI was performed 3 days after the injury showed high signals in the brain and spinal cord.


CONCLUSIONS
Both divers developed cerebro-spinal dysfunction. They had encephalopathy (manifested by loss of consciousness), which indicates bilateral cerebral dysfunction. DCS can occur even when dives are conducted according to the procedures described by the US Navy. The use of high-dose steroids has not been formally tested in DCS; their use is controversial.
Midlands Centre for Spinal Injuries, Robert Jones & Agnes Hunt Orthopaedic & District Hospital NHS Trust, Oswestry, Shropshire, UK.
S
S
Jallul
A
A
Osman
W
W
El-Masry
D000328:Adult; D001927:Brain Diseases / Q000209:etiology* / Q000473:pathology; D003665:Decompression Sickness / Q000150:complications* / Q000473:pathology; D004242:Diving; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology