Cerebral Dysfunction of a Diving Fisherman After Prophylactic Recompression Treatment: A Case Report

Prophylactic recompression treatment (PRT) is an empirical treatment conducted in China for divers who conduct repetitive diving or asymptomatic insufficient decompression to eliminate residual nitrogen and microbubbles and prevent decompression sickness (DCS).

We report a case of a 43-year-old healthy diving fisherman who experienced cerebral dysfunction after PRT. The fisherman suddenly experienced dizziness accompanied by vomiting, vertigo, nausea, confusion, and aphasia six hours after a 500kPa-PRT. Laboratory tests revealed a significantly elevated serum creatine kinase. No abnormalities were found by cranial computed tomography (CT), but the chest CT observed emphysema and pulmonary bullae. After undergoing another recompression treatment, the fisherman fully recovered without sequelae. Hence, it was deduced that the diver might have a cerebral arterial gas embolism (AGE).

The case suggests that although PRT for healthy diving fishermen is theoretically safe, there remains a rare possibility of decompression illness, including cerebral AGE or cerebral DCS. It is not crucial to differentiate these two conditions, as both require timely recompression treatment and, in most cases, can have a good prognosis.