Brain under pressure: Insights into diving-related lesions: a descriptive study

Area of Science:

• Neurology
• Radiology
• Diving Medicine

Background:

• Diving-related injuries pose a significant threat to the central nervous system (CNS).
• Type II decompression sickness (DCS) can result in brain lesions with characteristic patterns.

Purpose of the Study:

• To characterize the clinical and radiological features of brain involvement in diving injuries.
• To specifically focus on identifying lesions within the corpus callosum.

Main Methods:

• Retrospective study (2011-2023) of divers with acute neurological injuries.
• Data collection included diving history, clinical symptoms, and MRI findings (T1, T2, FLAIR, gradient echo, DWI).

Main Results:

• 10 out of 41 patients showed cerebral involvement, all male professional divers (mean age 41).
• Symptoms appeared rapidly post-dive (65.8% within 10 min), including sensory-motor deficits, vertigo, and headache.
• MRI revealed corpus callosum hyperintensities (T2 FLAIR), ischemic stroke, and other lesions; DWI indicated cytotoxic and vasogenic edema.

Conclusions:

• Cerebral DCS presents with diverse clinical and radiological patterns.
• Corpus callosum involvement is a significant finding, indicating vulnerability to ischemia and edema.
• Early clinical and imaging assessment is crucial for timely recompression therapy and improved outcomes.