{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T13:36:12Z","timestamp":1746711372579,"version":"3.40.5"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,9,1]]},"abstract":"<jats:p>Dive-related injuries are relatively common, but almost exclusively occur in recreational or scuba diving. We report 2 children with acute central nervous system complications after breath-hold diving. A 12-year-old boy presented with unilateral leg weakness and paresthesia after diving beneath the water surface for a distance of \u223c25 m. After ascent, he suddenly felt extreme thoracic pain that resolved spontaneously. Neurologic examination revealed right leg weakness and sensory deficits with a sensory level at T5. Spinal MRI revealed a nonenhancing T2-hyperintense lesion in the central cord at the level of T1\/T2 suggesting a spinal cord edema. A few weeks later, a 13-year-old girl was admitted with acute dizziness, personality changes, confusion, and headache. Thirty minutes before, she had practiced diving beneath the water surface for a distance of \u223c25 m. After stepping out, she felt sudden severe thoracic pain and lost consciousness. Shortly later she reported headache and vertigo, and numbness of the complete left side of her body. Neurologic examination revealed reduced sensibility to all modalities, a positive Romberg test, and vertigo. Cerebral MRI revealed no pathologic findings. Both children experienced a strikingly similar clinical course. The chronology of events strongly suggests that both patients were suffering from arterial gas embolism. This condition has been reported for the first time to occur in children after breath-hold diving beneath the water surface without glossopharyngeal insufflation.<\/jats:p>","DOI":"10.1542\/peds.2014-4095","type":"journal-article","created":{"date-parts":[[2015,8,11]],"date-time":"2015-08-11T00:38:58Z","timestamp":1439253538000},"page":"e687-e690","source":"Crossref","is-referenced-by-count":4,"title":["Presumed Arterial Gas Embolism After Breath-Hold Diving in Shallow Water"],"prefix":"10.1542","volume":"136","author":[{"given":"Stefani","family":"Harmsen","sequence":"first","affiliation":[{"name":"Departments of General Pediatrics, Neonatology, and Pediatric Cardiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Schramm","sequence":"additional","affiliation":[{"name":"Departments of General Pediatrics, Neonatology, and Pediatric Cardiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Karenfort","sequence":"additional","affiliation":[{"name":"Departments of General Pediatrics, Neonatology, and Pediatric Cardiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Christaras","sequence":"additional","affiliation":[{"name":"Trauma and Hand Surgery, Heinrich-Heine University, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Euler","sequence":"additional","affiliation":[{"name":"Trauma and Hand Surgery, Heinrich-Heine University, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ertan","family":"Mayatepek","sequence":"additional","affiliation":[{"name":"Departments of General Pediatrics, Neonatology, and Pediatric Cardiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Tibussek","sequence":"additional","affiliation":[{"name":"Departments of General Pediatrics, Neonatology, and Pediatric Cardiology and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2015,9,1]]},"reference":[{"issue":"11","key":"2021121021072331900_B1","first-page":"2211","article-title":"Neurologic complications of scuba diving.","volume":"63","author":"Newton","year":"2001","journal-title":"Am Fam Physician"},{"key":"2021121021072331900_B2","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/B978-0-7020-4087-0.00063-2","article-title":"Neurology and diving.","volume":"120","author":"Massey","year":"2014","journal-title":"Handb Clin Neurol"},{"issue":"5","key":"2021121021072331900_B3","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1378\/chest.81.5.648","article-title":"Can pulmonary barotrauma cause cerebral air embolism in a non-diver?","volume":"81","author":"Bayne","year":"1982","journal-title":"Chest"},{"issue":"1","key":"2021121021072331900_B4","first-page":"63","article-title":"Arterial gas embolism following a 1-meter ascent during helicopter escape training: a case report.","volume":"67","author":"Benton","year":"1996","journal-title":"Aviat Space Environ Med"},{"key":"2021121021072331900_B5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1539\/joh.43.56","article-title":"Neurological diving accidents in Japanese breath-hold divers: a preliminary report.","volume":"43","author":"Kohshi","year":"2000","journal-title":"J Occup Health"},{"issue":"1","key":"2021121021072331900_B6","first-page":"1","article-title":"Breath-hold diving and cerebral decompression illness.","volume":"37","author":"Moon","year":"2010","journal-title":"Undersea Hyperb Med"},{"issue":"1","key":"2021121021072331900_B7","first-page":"7","article-title":"Repetitive breath-hold diving causes serious brain injury.","volume":"37","author":"Tamaki","year":"2010","journal-title":"Undersea Hyperb Med"},{"issue":"14","key":"2021121021072331900_B8","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1080\/02640410903121351","article-title":"Decompression sickness in breath-hold divers: a review.","volume":"27","author":"Lemaitre","year":"2009","journal-title":"J Sports Sci"},{"issue":"1","key":"2021121021072331900_B9","first-page":"55","article-title":"Adverse events in competitive breath-hold diving.","volume":"33","author":"Fitz-Clarke","year":"2006","journal-title":"Undersea Hyperb Med"},{"key":"2021121021072331900_B10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mbs.2015.01.001","article-title":"Decompression sickness in breath-hold diving, and its probable connection to the growth and dissolution of small arterial gas emboli.","volume":"262","author":"Goldman","year":"2015","journal-title":"Math Biosci"},{"issue":"1","key":"2021121021072331900_B11","doi-asserted-by":"crossref","first-page":"74","DOI":"10.3357\/ASEM.2571.2010","article-title":"Suspected arterial gas embolism after glossopharyngeal insufflation in a breath-hold diver.","volume":"81","author":"Lin\u00e9r","year":"2010","journal-title":"Aviat Space Environ Med"},{"issue":"3","key":"2021121021072331900_B12","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00421-012-2494-6","article-title":"Transient ischemic attacks from arterial gas embolism induced by glossopharyngeal insufflation and a possible method to identify individuals at risk.","volume":"113","author":"Schiffer","year":"2013","journal-title":"Eur J Appl Physiol"},{"issue":"3","key":"2021121021072331900_B13","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3121\/cmr.2013.1173-8","article-title":"Hemoptysis due to breath-hold diving following chemotherapy and lung irradiation: a differential diagnosis; with authors\u2019 reply.","volume":"11","author":"Fijen","year":"2013","journal-title":"Clin Med Res"},{"issue":"4","key":"2021121021072331900_B14","first-page":"235","article-title":"Spontaneous pneumomediastinum in an 11-year-old boy after a shallow breath-hold dive.","volume":"43","author":"Laitila","year":"2013","journal-title":"Diving Hyperb Med"},{"issue":"4","key":"2021121021072331900_B15","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1097\/00006565-200108000-00010","article-title":"Spontaneous pneumomediastinum in a shallow-water\u2014diving child.","volume":"17","author":"Albaugh","year":"2001","journal-title":"Pediatr Emerg Care"},{"issue":"5","key":"2021121021072331900_B16","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/BF01955926","article-title":"Spontaneous pneumomediastinum in children.","volume":"150","author":"Versteegh","year":"1991","journal-title":"Eur J Pediatr"},{"key":"2021121021072331900_B17","first-page":"205","article-title":"Pulmonary barotrauma: a new look at mechanisms.","volume":"27","author":"Francis","year":"1997","journal-title":"SPUMS J"},{"issue":"3","key":"2021121021072331900_B18","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00381-014-2562-9","article-title":"Acute asymmetrical spinal infarct secondary to fibrocartilaginous embolism.","volume":"31","author":"Rengarajan","year":"2015","journal-title":"Childs Nerv Syst"},{"issue":"3","key":"2021121021072331900_B19","first-page":"302","article-title":"Breath hold diving as a brain survival response.","volume":"4","author":"Zeljko Dujic","year":"2013","journal-title":"Translational Neurosci"},{"issue":"2","key":"2021121021072331900_B20","doi-asserted-by":"crossref","first-page":"e87598","DOI":"10.1371\/journal.pone.0087598","article-title":"Dynamic cerebral autoregulation is acutely impaired during maximal apnoea in trained divers.","volume":"9","author":"Cross","year":"2014","journal-title":"PLoS ONE"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/3\/e687\/912238\/peds_2014-4095.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/3\/e687\/912238\/peds_2014-4095.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T06:47:14Z","timestamp":1639205234000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/136\/3\/e687\/61149\/Presumed-Arterial-Gas-Embolism-After-Breath-Hold"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,1]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,9,1]]},"published-print":{"date-parts":[[2015,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2014-4095","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2015,9,1]]}}}