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One hundred patients affected by S.A.H. have been studied, evaluating the possible correlations between clinical findings and hyponatremia. For a better understanding of hyponatremia during S.A.H., the hematic concentration of A.D.H. and A.N.P. have been determined and correlated with hyponatremia.

Forty five patients suffering by S.A.H., with I-III degree according to Hunt-Hess classification, have been studied with SPECT, performed within 72 hours from the hemorrhage, in order to evaluate early alterations of cerebral blood flow and their prognostic value. The patients with a clinical worsening showed an important diminution of C.B.F. detected by SPECT and a great amount of blood in the sub-arachnoidal spaces at the CT scan (III degree, according to Fischer). If these results will be confirmed with further studies, it could be possible to early identify a group of patients with a high risk of developing a cerebral vasospasm.

Hyponatremia is a state of relatively common observation among neurosurgical patients and it may determine or precipitate a condition of brain swelling in the head-injured. The quick reversal to normal values of serum sodium concentration may cause relevant neurological disturbances: they are related to peculiar neuropathological changes, the most representative of which is central pontine myelonilysis. Two cases (one in pediatric age) of head injured patients with brain damage resulting from rapid correction of a SIADH related hyponatremia are presented.

Between January 1983 and December 1987, 121 patients who sustained a cervical spine injury were treated at the Neurosurgical Department of Ospedali Riuniti Bergamo. In 55 patients the segment between C3 and C7 was involved. Different techniques and results in the management of these lesions are discussed.

Introduction: Neurological symptoms after breath-hold (BH) diving are often referred to as “Taravana” and considered a form of decompression sickness. However, the presence of “high” gas embolism after BH diving has never been clearly shown. This study showed high bubble formation after BH diving. Materials and methods: We performed transthoracic echocardiography on a 53-year-old male spearfishing diver (180 cm; 80 kg; BMI 24.7) 15 minutes before diving and at 15-minute intervals for 90 minutes after diving in a 42-meter-deep pool. Number of dives, bottom time and surface intervals were freely determined by the diver. Dive profiles were digitally recorded for depth, time and surface interval, using a freediving computer. Relative surface interval (surface interval/diving time) and gradient factor were calculated. Results: High bubble grades were found in all the recorded echocardiograms. From the first to third recording (45 minutes), Grade 4 Eftedal-Brubakk (EB) bubbles were observed. The 60-, 75- and 90-minute recordings showed a reduction to Grades 3, 2 and 1 EB. Mean calculated GF for every BH dive was 0.22; maximum GF after the last dive was 0.33. Conclusions: High bubble grades can occur in BH diving, as confirmed by echocardiographic investigation. Ordinary methods to predict inert gas super- saturation may not able to predict Taravana cases., This document is the accepted Authors' Copy of the paper published in UHM 2016, 43(4): 449-455. This paper has received funding from the European Union (EU)'s H2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 643712 to the project Green Bubbles RISE for sustainable diving (Green Bubbles). This paper reflects only the authors' view. The Research Executive Agency is not responsible for any use that may be made of the information it contains.