title: Brain damage in commercial breath-hold divers.
abstract: BACKGROUND
  Acute decompression illness (DCI) involving the brain (Cerebral DCI) is one of the most serious forms of diving-related injuries which may leave residual brain damage. Cerebral DCI occurs in compressed air and in breath-hold divers, likewise. We conducted this study to investigate whether long-term breath-hold divers who may be exposed to repeated symptomatic and asymptomatic brain injuries, show brain damage on magnetic resonance imaging (MRI).
  
  
  METHODS
  Our study subjects were 12 commercial breath-hold divers (Ama) with long histories of diving work in a district of Japan. We obtained information on their diving practices and the presence or absence of medical problems, especially DCI events. All participants were examined with MRI to determine the prevalence of brain lesions.
  
  
  RESULTS
  Out of 12 Ama divers (mean age: 54.9±5.1 years), four had histories of cerebral DCI events, and 11 divers demonstrated ischemic lesions of the brain on MRI studies. The lesions were situated in the cortical and/or subcortical area (9 cases), white matters (4 cases), the basal ganglia (4 cases), and the thalamus (1 case). Subdural fluid collections were seen in 2 cases.
  
  
  CONCLUSIONS
  These results suggest that commercial breath-hold divers are at a risk of clinical or subclinical brain injury which may affect the long-term neuropsychological health of divers.
authors.affiliation: Center for Hyperbaric Medicine and Environmental Health, University Hospital of the Ryukyus, Nishihara, Okinawa, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kohshi
authors.affiliation: Tamaki Hospital, Hagi, Yamaguchi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Tamaki
authors.affiliation: Faculty of Sport Sciences, University of Rouen, Mont-Saint-Aignan, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lemaître
authors.affiliation: Department of Neuro-radiology and Psychiatry, Shin-funagoya Hospital, Miyama, Fukuoka, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Okudera
authors.affiliation: Department of Environmental Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishitake
authors.affiliation: Divers Alert Network, Durham, North Carolina, United States of America.
authors.forename: Petar J
authors.initials: PJ
authors.lastname: Denoble
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D001930:Brain Injuries / Q000209:etiology* / Q000473:pathology*; D002545:Brain Ischemia / Q000209:etiology / Q000473:pathology; D062485:Breath Holding; D002544:Cerebral Infarction / Q000209:etiology / Q000473:pathology; D003665:Decompression Sickness / Q000150:complications / Q000503:physiopathology; D004242:Diving / Q000009:adverse effects*; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged