Right-to-left shunt and risk of decompression illness with cochleovestibular and cerebral symptoms in divers: Case control study in 101 consecutive dive accidents

Abstract

Based on our results, we conclude that major right-to-left shunt was associated with an increased incidence of cochleovestibular and cerebral decompression illness, suggesting paradoxical embolism as a potential mechanism.

Cerebellar infarction presenting as inner ear decompression sickness following scuba diving: A case report

“…The discovery of a large patent foramen ovale with ASA in this diver with no known cardiovascular risk factors was strictly compatible with the initial diagnosis of inner ear decompression sickness [2,3], but this association is also frequently observed in embolic cerebellar strokes in subjects younger than 40 [10].…”

“…This fairly uncommon acute illness (1 to 3 cases per 10,000 dives) mainly affects the central nervous system [1]. In 25-30% of cases, the inner ear is involved by in situ release of bubbles into endolymph or perilymph or air embolism in the labyrinthine artery [2,3]. The diver generally experiences varying degrees of rotational vertigo sometimes associated with cochlear signs during the hour following return to the surface.…”

Patent foramen ovale: A new disease?

“…Arterial gas embolism is usually due to air emboli arising from pulmonary barotrauma or from bubbles in the systemic venous circulation entering the arterial system [63]. This category [64,48,65,66] applies to a small number of patients (about 2.3/10 000 divers) [58] but has substantial implications not only for career professionals but also recreational divers and may also apply to high altitude test pilots. Prospective studies are still needed to assess whether RLS is to be considered a contraindication to scuba diving.…”

Tauchmedizinische Aspekte in der HNO-Heilkunde

“…Die Dekompressionserkrankung des Innenohrs zählt zur Dekompressionserkrankung Typ II und ist in der überwiegenden Zahl mit einem kardialen Rechts-Links-Shunt assoziiert [2,5]. Ein solcher Rechts-LinksShunt begünstigt die Arterialisierung venöser Gasbläschen, die in der Folge zu  embolischen Gefäßverschlüssen führen können.…”