A PathologicalStudy on Cerebral Lesions inDiver' s Decompression Sickness (DCS)

Histopathological analysis was done on brains of four autopsy cases of acute decompression sicknes (DCS). The findings of the brains in four cases of acuteDCS wassummarized as follows: 1) marked engorgement of the meningeal veins with marked stasis of blood with or without presence of intravascular air bubbles, 2) marked edema of the cerebral parenchyma with perivascular hemorrhage, 3) pallor spots around the venules and blood capillaries in the brain, especially in the deeper cortex and subcortical white matter, and 4) relatively-sharply defined foci of edematous necrosis in the deep layer of the white matter of the cerebrum, especially in the periventricular layer. As for the causes of the cerebral lesions in DCS, bubble embolization seemed to be the most important factor. Alteration of permeability of the blood vessels caused by trapping of very small bubble emboli should contribute significantly to the histogenesis of pallor spots. Pathological-anatomical analysis ascribed that the pathogenesis of focal edematous necrosis to marked disturbance of venous circulation due to bubble embloization with a superimposing severe shock. For the latter lesion of the brain, the etiology seemed identical with that of the spinal cord lision in DCS with apparent distruptions in the circulation of veins in and around thespinal cord.