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J Korean Soc Emerg Med > Volume 28(4); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(4): 387-390.
뇌 감압병의 3.0 테슬라 MRI 소견: 증례보고
강희동, 오세현, 정상구
울산대학교 의과대학 강릉아산병원 응급의학과
3.0 T MRI Findings in Cerebral Decompression Sickness: A Case Report
Hui Dong Kang, Se Hyun Oh, Sang Ku Jung
Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
Correspondence  Se Hyun Oh ,Tel: 033-610-5491, Fax: 033-610-4960, Email: emosh89@naver.com,
Received: April 25, 2017; Revised: April 28, 2017   Accepted: June 20, 2017.  Published online: August 31, 2017.
We presented a patient with cerebral decompression sickness, who showed predominant vasogenic edema on a 3.0 Tesla (3T) magnetic resonance imaging (MRI) findings, including diffusion-weighted image (DWI) and apparent diffusion coefficient (ADC) mapping. Within minutes of surfacing, he developed paresis of the right lower limb. During transport, he began shivering, followed by severe spasm that eventually progressed to a tonic-clonic seizure. Emergent hyperbaric oxygen therapy (HBOT) was performed with U.S. Navy treatment table 6A after a treatment of seizure activity. Brain MRI was performed after hyperbaric oxygen therapy to detect any cerebral lesions, which showed subcortical hyperintensity signal changes in the left fronto-parietal region on the ADC map. Overlying cortical hyperintensity on DWI sequences and cortical hypointensity on the ADC map were simultaneously observed. Moreover, these findings disappeared in a followup MRI with complete resolution of symptoms. These findings indicate that vasogenic edema can cause cerebral decompression sickness (DCS) and that 3T MRI with DWI and ADC mapping may be useful for diagnosing cerebral DCS. In addition, these findings suggest that DW-MRI may also be useful in predicting the prognosis of cerebral DCS.
Key words: Decompression sickness, Diffusion magnetic resonance imaging, Brain edema
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