Description

ABSTRACT

Schmitz G, Aguero S, Huertas Gabert LC. Case of Broca's Aphasia as an expression of cerebral

decompression sickness with advanced non-invasive monitoring during HBO2 treatment. Undersea

Hyperb Med. 2026 First Quarter; 53(1):91-97.

Introduction: We present a case of severe CNS decompression sickness (DCS) that included Broca’s

aphasia in a recreational diver, offering insights into the application of advanced non-invasive monitoring

during hyperbaric oxygen treatment (HBO2).

Case Report: This 64-year-old male diver experienced the onset of expressive aphasia, vertigo, and right-

sided hemiparesis about 30-120 minutes after surfacing following a rapid ascent after a deep dive.

Discussion: Initial monitoring with bispectral index (BIS) and density spectral array (DSA) revealed

significant asymmetry between cerebral hemispheres, particularly in spectral edge frequency (SEF)

values, with the left hemisphere showing a marked reduction during air breaks at HBO2 pressures. This

pattern resolved progressively over three HBO2 sessions, with full clinical recovery after four sessions,

coinciding with the resolution of this DSA hemispheric asymmetry. The case indirectly supports the

theoretical roles of microparticles and endothelial dysfunction in contributing to cerebral hypoperfusion

in DCS, beyond the conventional focus on gas bubbles, as reflected in the clinical findings and the clinical

gradient. This novel application of BIS-DSA in hyperbaric medicine offers promising potential for real-

time monitoring of cerebral involvement. It could enhance patient outcomes by guiding individualized

treatment in neurologically compromised DCS cases.

Keywords: Bispectral index; brain; cerebral blood flow; decompression sickness; density spectral array;

electroencephalography; microparticles

DOI: 10.22462/806