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Neurology 2000;55:1741-1743
© 2000 American Academy of Neurology
Brief Communications

Arteriovenous bubbles following cold water sport dives: Relation to right-to-left shunting

T. Gerriets, MD, K. Tetzlaff, MD, T. Liceni, C. Schäfer, MD, B. Rosengarten, MD, G. Kopiske, C. Algermissen, MD, N. Struck and M. Kaps, MD

From the Department of Neurology (Drs. Gerriets, Schäfer, Rosengarten, Kaps, Kopiske, and Liceni), Justus–Liebig–University, Giessen; the German Naval Medical Institute (Dr. Tetzlaff and N. Struck), Kronshagen; the 1st Department of Medicine (Dr. Tetzlaff), Christian–Albrechts–University, Kiel; and the Department of Neurology (Dr. Algermissen), Medical University at Luebeck, Germany.

Address correspondence and reprint requests to Prof. Dr. M. Kaps, Am Steg 14, 35385 Giessen, Germany; e-mail: Manfred.Kaps{at}Neuro.med.uni-Giessen.de

Neurologic injury subsequent to decompression from diving may be due to paradoxical arterialization of venous gas emboli. Of 40 divers who performed 53 open water dives after being tested for a patent foramen ovale (PFO), arterial gas emboli were detected in 7 of 13 dives, which resulted in venous bubbles. In five of these seven dives, there was evidence of a PFO by contrast transcranial Doppler sonography, indicating an increased risk of arterializing venous bubbles in divers with a PFO.




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