Abstract
BackgroundAcute decompression illness (DCI) involving the brain (Cerebral DCI) is one of the most serious forms of diving-related injuries which may leave residual brain damage. Cerebral DCI occurs in compressed air and in breath-hold divers, likewise. We conducted this study to investigate whether long-term breath-hold divers who may be exposed to repeated symptomatic and asymptomatic brain injuries, show brain damage on magnetic resonance imaging (MRI).Subjects and MethodsOur study subjects were 12 commercial breath-hold divers (Ama) with long histories of diving work in a district of Japan. We obtained information on their diving practices and the presence or absence of medical problems, especially DCI events. All participants were examined with MRI to determine the prevalence of brain lesions.ResultsOut of 12 Ama divers (mean age: 54.9±5.1 years), four had histories of cerebral DCI events, and 11 divers demonstrated ischemic lesions of the brain on MRI studies. The lesions were situated in the cortical and/or subcortical area (9 cases), white matters (4 cases), the basal ganglia (4 cases), and the thalamus (1 case). Subdural fluid collections were seen in 2 cases.ConclusionThese results suggest that commercial breath-hold divers are at a risk of clinical or subclinical brain injury which may affect the long-term neuropsychological health of divers.
Highlights
Acute decompression illness (DCI) involving the brain (Cerebral DCI) is one of the most serious forms of divingrelated injuries which may leave residual brain damage
Subdural fluid collections were seen in 2 cases. These results suggest that commercial breath-hold divers are at a risk of clinical or subclinical brain injury which may affect the long-term neuropsychological health of divers
Decompression illness (DCI), which includes bubble disease from decompression sickness and arterial gas embolism is well known in compressed-air divers
Summary
Acute decompression illness (DCI) involving the brain (Cerebral DCI) is one of the most serious forms of divingrelated injuries which may leave residual brain damage. Cerebral DCI occurs in compressed air and in breath-hold divers, likewise. We conducted this study to investigate whether long-term breath-hold divers who may be exposed to repeated symptomatic and asymptomatic brain injuries, show brain damage on magnetic resonance imaging (MRI). Decompression illness (DCI), which includes bubble disease from decompression sickness and arterial gas embolism is well known in compressed-air divers. Several cases of DCI have been reported in professional and sport breath-hold divers [3], [4], [5], [6]. Our survey of commercial breath-hold divers (Ama) in Japan have shown that repetitive, working breath-hold dives can induce neurological DCI. Based on the reported symptoms and neuro-radiological findings, brain lesions were prominent in this group [7], [8]
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