Nonaneurysmal Subarachnoid Hemorrhage in Scuba Diving.

Abstract

Decompression illness often presents with a wide variety of vague neurologic symptoms. Animal models have suggested that intracranial hemorrhages may result from nitrogen bubble ischemic insults. However, there is a paucity of cases and no known case reported to date of non-aneurysmal subarachnoid hemorrhage after rapid ascension from diving. A 60-year-old man presented with headache, nausea, emesis, and confusion 2 days after ascending rapidly from scuba diving. Given the severity and his symptoms unremitting despite oxygen at home, a computed tomography scan of the head was obtained revealing a prepontine and right sylvian fissure subarachnoid hemorrhage with ventriculomegaly. No underlying vascular abnormality was discovered. The patient was discharged from the hospital posthemorrhage day 7, neurologically intact. In patients presenting with persistent headache, nausea, emesis and/or other neurologic symptoms after diving, health care providers should consider intracranial hemorrhage in their work up.