AJR. American journal of roentgenology
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Diving accidents related to barotrauma constitute a unique subset of ischemic insults to the CNS. Victims may demonstrate components of arterial gas embolism, which has a propensity for cerebral involvement, and/or decompression sickness, with primarily spinal cord involvement. Fourteen patients with diving-related barotrauma were studied with MR imaging of the brain and spinal cord and with CT of the brain. ⋯ However, scans obtained early in our study were frequently limited by technical constraints. MR of the brain is more sensitive than conventional CT scanning techniques in detecting and characterizing foci of cerebral ischemia caused by embolic barotrauma to the CNS. Although spinal MR may be less successful in the localization of spinal cord lesions related to decompression sickness, these lesions were previously undetectable by other neuroimaging methods.
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In a prospective study of 225 consecutive pediatric patients who required sedation for CT imaging, we monitored oral and nasal air flow, transcutaneous oxygen saturation, and cardiac rate and rhythm before and after the administration of IV Nembutal. In addition, the first 50 patients in this series had blood pressures mechanically monitored at 1-min intervals. There was no significant change in the cardiac rate, rhythm, or blood pressure in any patient. ⋯ Only one patient required prolonged observation, and one patient demonstrated an idiosyncratic hyperactive response. The sedation failure rate was less than 1%. The average dose of sedation was reduced when compared with IM Nembutal because the rapid onset of activity after IV administration allowed titration of dose to patient response.