Cerebellar infarction presenting as inner ear decompression sickness following scuba diving: a case report.

Abstract

INTRODUCTION:

Inner ear decompression sickness following scuba diving is not uncommon and the characteristic features of this disorder are acute peripheral vestibular syndrome, sometimes associated with cochlear signs, requiring urgent hyperbaric oxygen therapy. Cerebellar infarction can also mimic isolated peripheral vestibulopathy.

CASE REPORT:

The authors report the case of a 47-year-old man in good general health admitted with acute left vestibular dysfunction suggestive of inner ear decompression sickness 6 hours after scuba diving. Normal videonystagmography and delayed onset of occipital headache finally led to brain MRI that confirmed the presence of recent ischaemic infarction in the territory of the medial branch of the posterior inferior cerebellar artery. Complementary investigations revealed the presence of a patent foramen ovale with atrial septal aneurysm. No underlying atherosclerotic disease or clotting abnormalities were observed.

DISCUSSION/CONCLUSION:

Cerebellar infarction can present clinically with features of inner ear decompression sickness following scuba diving. An underlying air embolism mechanism cannot be excluded, particularly in patients with a large right-to-left circulatory shunt and no other cardiovascular risk factors.

• Authors: E Gempp, P Louge, B Soulier, P Alla
• Journal: European annals of otorhinolaryngology, head and neck diseases (Eur Ann Otorhinolaryngol Head Neck Dis) Vol. 131 Issue 5 Pg. 313-5 (Nov 2014) ISSN: 1879-730X [Electronic] France
• PMID: 24954030 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Topics

• Atrial Septum (diagnostic imaging)
• Decompression Sickness (diagnosis)
• Diagnosis, Differential
• Diffusion Magnetic Resonance Imaging
• Diving (adverse effects)
• Foramen Ovale, Patent (diagnosis)
• Headache (etiology)
• Heart Aneurysm (diagnosis)
• Humans
• Infarction, Posterior Cerebral Artery (diagnosis)
• Male
• Middle Aged
• Nystagmus, Pathologic (etiology)
• Ultrasonography