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Internal carotid artery dissection in stroke from SCUBA diving: a case report.
J W Gibbs1, C A Piantadosi, E W Massey
1Department of Medicine (Neurology), Duke University Medical Center, Durham, NC 27710, USA.
Summary
SCUBA divers can experience stroke from arterial gas embolism or internal carotid artery (ICA) dissection. This case highlights ICA dissection as a potential cause of stroke after rapid ascent from diving.
Area of Science:
- Neurology
- Diving Medicine
- Vascular Surgery
Background:
- Neurological complications from SCUBA diving, such as arterial gas embolism and decompression sickness, are recognized risks.
- While arterial gas embolism is the most common cause of stroke in divers, other mechanisms like internal carotid artery (ICA) dissection are possible.
Observation:
- A 38-year-old female diver experienced headache, nausea, vomiting, and left hemiparesis after a rapid ascent from 120 feet.
- Initial treatment for decompression illness in a hyperbaric chamber was administered.
Findings:
- Neurological workup revealed a right internal carotid artery dissection.
- This dissection was identified as the cause of the central nervous system infarction.
Implications:
- Rapid ascent during SCUBA diving poses a risk for ICA dissection and subsequent stroke.
- Clinicians should consider ICA dissection in divers presenting with stroke symptoms post-dive.
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