Nonaneurysmal Subarachnoid Hemorrhage in Scuba Diving

Decompression illness is a known risk in scuba diving, often causing neurological symptoms. While nitrogen bubbles have been linked to intracranial injuries in animal studies, clinical evidence remains limited. No prior reports have described non-aneurysmal subarachnoid hemorrhage following rapid ascent from diving. This gap in clinical literature motivated further investigation into neurological outcomes after diving. Prior research has shown that rapid pressure changes can lead to gas embolism and neurological compromise. However, the specific mechanism linking diving to subarachnoid hemorrhage remains unclear. This uncertainty highlights the need for case studies to expand understanding of diving-related neurological injuries. The absence of prior human cases underscores the novelty of this report.

This case report aimed to document a rare instance of non-aneurysmal subarachnoid hemorrhage following scuba diving. The patient presented with neurological symptoms after rapid ascent, prompting investigation into potential intracranial causes. The goal was to raise awareness among clinicians about the possibility of hemorrhage in diving-related decompression illness. The study sought to contribute to the limited clinical literature on this topic. No prior human cases had been reported, making this an important addition to the field. The report emphasizes the importance of considering intracranial hemorrhage in post-diving neurological presentations. This case highlights the diagnostic challenges in distinguishing decompression illness from other neurological conditions. The findings may help guide future clinical assessments of similar cases.

The study involved a single 60-year-old male patient who experienced neurological symptoms after rapid ascent from scuba diving. Clinical evaluation included a detailed medical history and physical examination. A head CT scan was performed to assess for intracranial pathology. No vascular abnormalities were identified in imaging studies. The patient was monitored for neurological stability during hospitalization. Symptom progression was tracked over a seven-day hospital stay. Discharge criteria were based on neurological assessment and imaging results. The report synthesizes clinical findings with prior animal model data on nitrogen bubbles and cerebral injury.

The patient presented with headache, nausea, vomiting, and confusion two days post-diving. CT imaging revealed prepontine and right sylvian fissure subarachnoid hemorrhage. Ventriculomegaly was also observed on imaging. No underlying aneurysm or vascular malformation was detected. Symptoms resolved sufficiently for discharge on day seven post-hemorrhage. The patient was neurologically intact at discharge. No recurrence of symptoms was reported post-discharge. The case suggests a possible link between rapid ascent and subarachnoid hemorrhage.

The authors propose that non-aneurysmal subarachnoid hemorrhage may occur after rapid ascent from scuba diving. This case adds to the limited clinical evidence on diving-related neurological injuries. The absence of vascular abnormalities supports a non-vascular cause. The findings suggest that clinicians should consider intracranial hemorrhage in post-diving neurological presentations. No prior human cases had been reported, making this a novel contribution. The authors suggest that nitrogen bubble-induced ischemia may be a contributing factor. The patient's neurological recovery implies a potentially reversible process. The report emphasizes the need for further clinical observation and documentation of similar cases.