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Central nervous system decompression sickness: latency of 1070 human cases
T J Francis1, R R Pearson, A G Robertson
1Diving Medicine Department, Naval Medical Research Institute, Bethesda, MD 20814-5055.
Undersea Biomedical Research
|November 1, 1988
Summary
Central nervous system (CNS) decompression sickness (DCS) typically presents rapidly after hyperbaric exposure. Over half of cases show symptoms within 10 minutes, with cerebral DCS appearing faster than spinal cord DCS.
Area of Science:
- Diving Medicine
- Neurology
- Hyperbaric Medicine
Background:
- Central nervous system (CNS) decompression sickness (DCS) presentation timing and pathogenesis remain unclear.
- Understanding symptom onset is crucial for diagnosing and treating dysbaric illness.
Purpose of the Study:
- To determine the time interval between surfacing from hyperbaric exposure and the onset of CNS DCS symptoms.
- To analyze temporal patterns differentiating cerebral and spinal cord DCS.
Main Methods:
- Analysis of 1070 human CNS DCS cases from literature and treatment records.
- Review of case histories and clinical series.
Main Results:
- CNS DCS generally presents rapidly, with over 50% of cases symptomatic within 10 minutes of returning to 1 ATA.
- Symptom onset was delayed beyond 1 hour in only 15% of cases.
- Cerebral DCS onset (median ~3 minutes) was faster than spinal cord DCS onset (median ~9 minutes).
Conclusions:
- The rapid onset of CNS DCS has implications for diagnosis and treatment protocols.
- Findings may inform safety guidelines for hyperbaric exposures and diving practices.
- The temporal patterns provide insights into potential pathogenic mechanisms of CNS DCS.
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