another blood vessel dissection associated with scuba diving

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gkwalt

Contributor
Scuba Instructor
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Location
Fallston,MD
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There have been several posts regarding cranial and extracranial artery dissection associated with scuba. This one involves the vertebral artery. I personally suffered a carotid dissection many years ago from a fall while water skiing which resulted in hyperextension of my neck. It doesn't state how the diver in this case entered the water, i.e., boat or shore, but I have seen may giant strides from boat decks which were less than graceful. Is it possible that these violent entries be causing some of these injuries?



How to cite this URL:

Chojdak-Lukasiewicz J, Dziadkowiak E, Bladowska J, Paradowski B. Vertebral artery dissection and stroke after scuba diving. Neurol India [serial online] 2014 [cited 2015 Jun 12];62:711. Available from: Vertebral artery dissection and stroke after scuba diving Chojdak-Lukasiewicz J, Dziadkowiak E, Bladowska J, Paradowski B Neurol India


Sir,

A 27-year-old man without past medical history developed vertigo and gait imbalance two hours after diving in cold water. The magnetic resonance imaging revealed ischemic lesion in the right side of medulla oblongata in the area of right posterior inferior artery (PICA). Computerized tomography-angiography (CTA) showed right vertebral artery (VA) dissection [Figure 1]a and b. Six months later patient had no symptoms and the neurological examination was normal. The follow-up magnetic resonance examination showed partial regression of the previous ischemic lesion and the CTA revealed normal right VA [Figure 1]c and d. The association between scuba diving and cerebral arterial dissection is known but rare. [1],[2]
ni_2014_62_6_711_149455_f1.jpg
Figure 1: Brain MR shows an ischemic lesion (arrow) in the right side of the medulla oblongata (a). CT angiography (b), reveals dissection of the right vertebral artery (VA) at the level of C2-C3. The follow-up MR (c) Regression of the lesion, the CT angiography (d) Demonstrates the normal right VA

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It doesn't state how the diver in this case entered the water, i.e., boat or shore, but I have seen may giant strides from boat decks which were less than graceful. Is it possible that these violent entries be causing some of these injuries?

It would seem possible. Be sure to look straight ahead, not upward or downward, and hold the reg & mask snugly to your face with a hand.

Cheers,

DocVikingo
 
Another possible entry would be backwards over the gunwale of a boat.
 

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