title: Stroke in a scuba diver with patent foramen ovale.
abstract: Patent foramen ovale (PFO) is a frequent condition which carries a significant risk for stroke when associated with deep venous thrombosis and primary or secondary coagulation abnormalities. Here, we describe a patient in which scuba diving is thought to be associated with stroke in a subject with an otherwise clinically silent PFO. During a rapid ascent a 43-year-old-scuba diver reported weakness and paresthesias in the right arm which lasted about 10 min. He presented similar symptoms 2 days later 1 h after diving, and a third time on his flight back home. The MRI showed multiple hyperintense areas on T2-weighted images in the white matter. Transoesophageal echocardiography (TEE) showed a PFO, whilst all haematological and haemocoagulation tests were negative. Scuba diving may constitute a patho-physiological condition in the presence of PFO as breath-holding promotes right-to-left shunt and arterialization of venous bubbles.
authors.affiliation: Dipartimento di Scienze Neurologiche, Università degli Studi La Sapienza, viale dell'Università no. 30, 00185 Rome, Italy. carla.buttinelli@uniroma1.it
authors.forename: Carla
authors.initials: C
authors.lastname: Buttinelli
authors.forename: Mario
authors.initials: M
authors.lastname: Beccia
authors.forename: Corrado
authors.initials: C
authors.lastname: Argentino
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D004242:Diving; D004569:Electroencephalography; D004576:Electromyography; D006344:Heart Septal Defects, Atrial / Q000150:complications* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D017585:Ultrasonography, Doppler, Transcranial