title: Cerebellar infarction presenting as inner ear decompression sickness following scuba diving: a case report.
abstract: BACKGROUND
  Inner ear decompression sickness following scuba diving is not uncommon and the characteristic features of this disorder are acute peripheral vestibular syndrome, sometimes associated with cochlear signs, requiring urgent hyperbaric oxygen therapy. Cerebellar infarction can also mimic isolated peripheral vestibulopathy.
  
  
  METHODS
  The authors report the case of a 47-year-old man in good general health admitted with acute left vestibular dysfunction suggestive of inner ear decompression sickness 6 hours after scuba diving. Normal videonystagmography and delayed onset of occipital headache finally led to brain MRI that confirmed the presence of recent ischaemic infarction in the territory of the medial branch of the posterior inferior cerebellar artery. Complementary investigations revealed the presence of a patent foramen ovale with atrial septal aneurysm. No underlying atherosclerotic disease or clotting abnormalities were observed.
  
  
  CONCLUSIONS
  Cerebellar infarction can present clinically with features of inner ear decompression sickness following scuba diving. An underlying air embolism mechanism cannot be excluded, particularly in patients with a large right-to-left circulatory shunt and no other cardiovascular risk factors.
authors: Service de médecine hyperbare et expertise plongée, hôpital d'instruction des Armées Sainte-Anne, BP 600, 83800 Toulon cedex 9, France. Electronic address: gempp@voila.fr.
authors: E
authors: E
authors: Gempp
authors: Service de médecine hyperbare et expertise plongée, hôpital d'instruction des Armées Sainte-Anne, BP 600, 83800 Toulon cedex 9, France.
authors: P
authors: P
authors: Louge
authors: Service d'imagerie médicale, hôpital d'instruction des Armées Sainte-Anne, BP 600, 83800 Toulon cedex 9, France.
authors: B
authors: B
authors: Soulier
authors: Service de neurologie, hôpital d'instruction des Armées Sainte-Anne, BP 600, 83800 Toulon cedex 9, France.
authors: P
authors: P
authors: Alla
mesh_terms: D054087:Atrial Septum / Q000000981:diagnostic imaging; D003665:Decompression Sickness / Q000175:diagnosis; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D004242:Diving / Q000009:adverse effects*; D054092:Foramen Ovale, Patent / Q000175:diagnosis; D006261:Headache / Q000209:etiology; D006322:Heart Aneurysm / Q000175:diagnosis; D006801:Humans; D020762:Infarction, Posterior Cerebral Artery / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000209:etiology; D014463:Ultrasonography
keywords: Cerebellar infarction; Decompression sickness; Inner ear; Scuba diving