Spinal Cord Decompression Sickness

We read with interest the case report by Manabe et al (1) Presumed Venous Infarction in Spinal Decompression Sickness, in the AJNR. The authors stated that, to their knowledge, no previous reports have described MR signal abnormalities in the spinal cord associated with this syndrome; however, a valuable article by Warren et al was published in the November 1988 issue of the AJR and in the September/October 1988 issue of the AJNR (2) describing the same MR signal abnormalities in the spinal cord in decompression sickness (DCS) type II. In 1997, Reuter et al again described this MR finding in Acta Radiologica (3), and we described reversible MR signal abnormalities in the spinal cord associated with DCS type II after successful hyperbaric oxygen therapy (4).

We do, in conclusion, believe that Manabe and colleagues' report provides further evidence of the venous infarction theory as the pathophysiologic mechanism of involvement of the spinal cord in DCS type II and points to the usefulness of hyperbaric oxygen therapy in the treatment of the syndrome.