[abstract] MECHANISMS IN SPINAL CORD DECOMPRESSION SICKNESS: CLINICAL FEATURES

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[abstract] MECHANISMS IN SPINAL CORD DECOMPRESSION SICKNESS: CLINICAL FEATURES

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Title: [abstract] MECHANISMS IN SPINAL CORD DECOMPRESSION SICKNESS: CLINICAL FEATURES
Author: James, PB; Hills, BA
Abstract: In order to test a model of spinal decompression sickness it is essential to carefully review clinico-pathological features already recorded. These include the increasing incidence in deep, long-duration air dives (1) and the rarity of cases in heliox diving (2). Involvement of the cervical cord has been described (3) but lesions of the thoracic region where the white to gray matter ratio is 7:l is more common. Studies of the uptake of highly lipid-soluble anaesthetic agents (4) and the distribution of extravascular gas in the cord on decompression (5) indicate a factor overlooked, the importance of blood flow in the grey matter to the gas flux in the adjacent white matter. Bilateral lesions are usually symmetrical but unilateral lesions occur and also sensory and motor disturbances may develop separately suggesting that initially a major disturbance of blood flow to the whole cord, is not involved and the symptoms are due to a localised disturbance associated with gas formation. This is confirmed both by the rapid response to immediate recompression therapy and also by the occasional recurrence of identical symptoms following decompression. In unresolved cases the paresis is followed by spasticity indicating that the lower motor neurone is intact. The pathology in cases where death occurs rapidly often includes severe macroscopic disruption of the cord and haemorrhage (6). However, in non-fatal cases clinical examination may reveal very localised lesions, for example, in the lateral spino-thalmic tract. (7). The overall picture with scattered lesions in the cord and occasional cerebral lesions is similar in presentation to disseminated sclerosis.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting held May 25-29, 1981. The Asilomar Conference Center, Pacific Grove, California (http:www.uhms.org)
URI: http://archive.rubicon-foundation.org/4884
Date: 1981

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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