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Here's a head scratcher (pun intended) -- scuba diving post craniectomy. I'm talking about a small (2-by-3 cm) craniectomy. Does anyone know of a good scuba medicine resource or have their own theories on this topic? There's very little out there. Tried pubmed and uptodate. All ideas welcome...

sounds like a bad idea to me.  check the undersea and hyperbaric medicine society website.  they may have some resources. 

 

I operate a hyperbaric chamber and unless the benefit of the therapy vastly outweighed the risk, I would not put that patient into the chamber. 

Second the above. I'm a fairly advanced diver and wouldn't risk it. Most of the dive physics act on air filled compartments in the body, but there isn't really anyway to be certain that something more serious won't occur if there is an accident at depth.

 

As a side note: depending on the condition the craniectomy was performed to treat, he may meet other criteria to not continue diving.

At 50 feet of seawater you're experiencing 2.5 atmospheres of pressure...  The skin overlying the skull is very thick, but the skull of course provides structural support.  The area of the craniectomy would have to support 36.75 pounds per square inch of pressure...  I'm not certain that the underlying brain parenchyma would like that very much. 

would it be silly to wear a helmet when scuba-ing 

 

i don't know if you guys can tell but i don't spend much time in the water

 

It wouldn't change the amount of pressure that the scalp bears underwater, or in theory shouldn't anyway. 

I'd look either at DAN or UHMS...as a Diving Medicine Tech with the military, I wouldn't sign off anyone like that and I doubt any of the Undersea Medical Consultants I worked with would either.

 

$0.02 (Cdn)

 

SK

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