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list,

The journal article below provides some  
_direct_ experimental evidence that a Patent Foramen 
Ovale (PFO) or other shunt mechanism can result in 
bubbles in your brain during decompression.  Brain bubbles 
are generally a bad idea since they can result in permanent 
paralysis, brain damage, or death.

The authors used ultrasound to track bubbles from the
veins through a PFO, into the carotid arterys and in the 
brain of the subjects.

For those of you new to the list I'll summarize:
PFO's exist in ~30% of the population and may predispose
you to getting an Arterial Gas Embolism (AGE) leading to
Central Nervous System (CNS) DCI hit during
a less than perfect deco.  Bottom line is that if you 
are starting deco diving you should be tested for a PFO 
or other shunt, and modify your diving based on the
results.  More info should be available in the techdiver
archives.

Article citation and abstract:

"Arterial gas embolism after decompression: correlation with 
right-to-left shunting."

Neurology 1999 Jan 15;52(2):401-4   (ISSN: 0028-3878)

Ries S; Knauth M; Kern R; Klingmann C; Daffertshofer M; 
Sartor K; Hennerici M [Find other articles with these

Department of Neurology, University of Heidelberg, 
Klinikum Mannheim, Germany.
ries@ne*.ma*.un*.de*.

ABSTRACT

Paradoxical gas embolism is a possible cause of neurologic 
sequelae after decompression in divers. The authors
detected arterial bubbles after decompression from chamber 
dives in two of six divers using transcranial Doppler
sonography (TCD). Arterial bubbles correlated with the 
size of right-to-left shunting as diagnosed by contrast
The pathway of spontaneous paradoxical embolism was tracked 
for the first time, supporting the concept of paradoxical 
gas embolism as a cause of early neurologic sequelae after 
decompression in at-risk divers. 

Major Subject Heading(s)
Minor Subject Heading(s)
	Decompression Sickness
	Diving
	Embolism, Air [etiology]
	Prosthesis Implantation

Indexing Check Tags: Comparative Study; Female; Human; Male

Language: English
MEDLINE Indexing Date: 199904
Publication Type: JOURNAL ARTICLE
Unique NLM Identifier: 99129747
Journal Code: A; M 

Later,

Don W.
--
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