Cerebral arterial gas embolism (CAGE) during open water scuba certification training whilst practising a controlled emergency swimming ascent

We report the case of a 23-year-old male novice diver who sustained cerebral arterial gas embolism (CAGE) during his open water certification training whilst practising a free ascent as part of the course. He developed immediate but transient neurological symptoms that had resolved on arrival to hos...

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Bibliographic Details
Published inDiving and hyperbaric medicine Vol. 53; no. 4; p. 345
Main Authors Banham, Neil, da Silva, Elisabete, Lippmann, John
Format Journal Article
LanguageEnglish
Published Australia 20.12.2023
Subjects
Adult
Barotrauma - complications
Decompression Sickness - etiology
Diving - adverse effects
Embolism, Air - diagnostic imaging
Embolism, Air - etiology
Embolism, Air - therapy
Humans
Male
Oxygen
Pneumothorax - etiology
Swimming
Young Adult
Pneumothorax
Diving accidents
Emergency ascent
Case reports
Pneumomediastinum
Pulmonary barotrauma
CESA
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Summary:We report the case of a 23-year-old male novice diver who sustained cerebral arterial gas embolism (CAGE) during his open water certification training whilst practising a free ascent as part of the course. He developed immediate but transient neurological symptoms that had resolved on arrival to hospital. Radiological imaging of his chest showed small bilateral pneumothoraces, pneumopericardium and pneumomediastinum. In view of this he was treated with high flow normobaric oxygen rather than recompression, because of the risk of development of tension pneumothorax upon chamber decompression. There was no relapse of his neurological symptoms with this regimen. The utility and safety of free ascent training for recreational divers is discussed, as is whether a pneumothorax should be vented prior to recompression, as well as return to diving following pulmonary barotrauma.
ISSN:1833-3516
DOI:10.28920/dhm53.4.345-350