Nervous System

Approximately two thirds of DI affects the nervous system. Although clinical features may be ambiguous a distinction is made between three potential locations of injury: (1) the spinal cord, (2) cerebrum and (3) peripheral nerves. In each case, the primary mechanism may be vascular (embolic) or extra-vascular.

In a review of 1070 cases of neurological decompression sickness, Francis et al discovered that 56% occurred within 10 minutes - some even prior to surfacing 72. Even when considering the 768 cases of obvious spinal cord injury in this series the majority still presented within 10 minutes of surfacing. Therefore any mechanistic theory for DI would have to account for this short latency. Conversely, there were 44% of cases that developed clinical manifestations as long as 48 hours after surfacing. This supports the probability of multiple mechanisms with varying latencies.

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